Biliary tract and Cancer Flashcards
cholangiocarcinoma
bile duct cancer, 65% perihilar, 30% are intrahepatic, 5% are distal extrahepatic
Jaundice
Epidemiology- 3% of GI cancers
Typically of late adulthood
narrow the lumen of the common bile duct–> increased bilirubin and bile in the blood–> pruritis
Primary bilirary cholangitis- only microscopic biliar ducts
Usually an adenocarcinoma
Cholangiocarcinoma risk factors
Primary sclerosing cholangitis
Biliary cysts
biliary parasitosis (clonorchis and opisthorcis)
Thortrast exposure
Primary sclerosing cholangitis (PSC)
strictures of intra/extra hepatic ducts
Beaded appearance
can be hilum
can also have colitis
Ultrasound, MRCP or ERCP
Periductal onion skin fibrosis
Bile duct diseases PBC vs PSC
PBC: females, intrahepatic, ERCP looks normal, AMA
PSC: Males, intra/extra, abnnormal ERCP, ulcerative colitis, CA risk, peds pts
biliary cysts
type 1 - 50-85% (Extrahepatic only)
type4: 15-35% (multiple cysts, extrahepatic and/or intrahepatic)
type 5: 20% (intrahepatic only, carolis disease)
biliary parasitosis
Clonorchis sinesis- chinese liver fluke, asymptomatic, cholangitis, chronic infection–> cholangiocarcinoma, treat with antihelminthic therapy
opisthorchiasis- liver fluke of cats and dogs and fish eaters
gallbladder cancer
adenocarcinoma, 75% of cases, uncommon, and fatal, womens disease
Risk factor- porcelain gallbladder, polyps (PSC), Cholethiasis (dont take out the gall bladder if asymptomatic
Porcelain gallbladder
Chronic cholecystitis with intramural calcification of the gallbladder wall
pre cancerous condition
gallbladder polyps
Cholesterol- abnormal deposits of triglycerides, cholesterol precursors, and cholesterol esters into the gall bladder mucosa
Inflammatory- granulation and fibrous tissue with plasma cells and lymphocytes
Adenomas- benign glanduloar tumors with potential for malignancy
malignancy related to size
PSC
