- HEPATOBILIARY SYSTEM
- BILIARY CARCINOMA
- Armed Forces Institute of Pathology
- On gross inspection, this could be either a primary or metastatic neoplasm to the liver. The umbilicated nature of the masses strongly suggests an epithelial origin, as carcinomas incite a profound desmoplastic response. In the central, older parts of the neoplasm the collagen that is laid down will contract first, resulting in a concavity to this part of te tumor. Determination as to whether this is a primary tumor of the liver - a biliary carcinoma, or simply foci of metastasis of a carcinoma in another location, such as a mammary carcinoma, will, in the absence of an obvious primary neoplasm elsewhere, will likely require histology. And, if all you get is a piece of the liver, and nothing else as a submission, be prepared to utilized immunohistochemical stains like cytokeratin 7 to try to establish that it is indeed biliary in origin. It is not always as easy as it sounds, as the liver is a common site of carcinoma metastatis, especially poorly-differentiated ones.