Intrahepatic Bile Duct Carcinoma with Clonorchiasis

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  • 肝吸虫症に合併した肝内胆管癌の1例

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Abstract

A 62-year-old man was admitted to our hospital because of biliary system enzyme increase pointed out in a medical examination. Abdominal CT scan revealed a mass lesion, 3 cm in diameter, in the hepatic left lobe and an adjacent expanded intrahepatic bile duct. The cytodiagnosis of the bile revealed class II, and a large number of ova of parasites of Clonorchis sinensis were found. This patient had a history of consuming raw crucian carp. After internal use of praziquantel, we diagnosed this as intrahepatic bile duct carcinoma complicated with clonorchiasis and performed hepatic left lobe resection. Poorly differentiated adenocarcinoma was confirmed by histopathology. Lymphocytic infiltration and fibrosis occurred around the adenocarcinoma, and changes were found after chronic cholangitis. Other than bile duct stone the only potential cause of the chronic inflammation in this case was Clonorchis sinensis. We suspected chronic inflammation due to clonorchiasis associated with cholangiocarcinoma development. If the patient has a diet history of raw freshwater fish, examination of feces or duodenal juice analysis should be performed. If clonorchis and ova of parasites are observed, it is necessary to deworm, and to consider the likelihood of accompanying cholangiocarcinoma.

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