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The Korean Journal of Pathology 1987;21(3): 185-191.
Secondary Biliary Cirrhosis in A Case with Intraductal Growth of Hepatocellular Carcinoma.
Hyung Geun Song, Yong Il Kim, Chung Yong Kim, Soo Tae Kim
1Department of Pathology, College of Medicine, Seoul National University, Seoul, Korea.
2Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
3Department of Surgery, College of Medicine, Seoul National University, Seoul, Korea.
4Liver Research Institute, College of Medicine, Seoul National University, Seoul, Korea.
ABSTRACT
A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.