BILE DUCTS – PERIHILAR (ICD‐O‐3 C24.0)


EXTRAHEPATIC BILE DUCTS – PERIHILAR (ICD‐O‐3 C24.0)


Rules for Classification


The classification applies to carcinomas of the extrahepatic bile ducts of perihilar localization (Klatskin tumour). Included are the right, left and common hepatic ducts.


Anatomical Sites and Subsites (Fig. 221)


Perihilar cholangiocarcinomas are tumours located in the extrahepatic biliary tree proximal to the origin of the cystic duct.

Schematic illustration of Anatomical Sites and Subsites.

Fig. 221


Regional Lymph Nodes


The regional nodes are the hilar and pericholedochal nodes in the hepatoduodenal ligament.


TNM Clinical Classification


T – Primary Tumour



























TX Primary tumour cannot be assessed
T0 No evidence of primary tumour
Tis Carcinoma in situ
T1 Tumour confined to the bile duct, with extension up to the muscle layer or fibrous tissue (Fig. 222)
T2a Tumour invades beyond the wall of the bile duct to surrounding adipose tissue (Fig. 223)
T2b Tumour invades adjacent hepatic parenchyma (Fig. 224)
T3 Tumour invades unilateral branches of the portal vein or hepatic artery (Fig. 225a)
T4 Tumour invades the main portal vein or its branches bilaterally; or the common hepatic artery; or the second‐order biliary radicals bilaterally; or unilateral second‐order biliary radicals with contralateral portal vein or hepatic artery involvement (Fig. 225b)
Schematic illustration of tumour confined to the bile duct, with extension up to the muscle layer or fibrous tissue.

Fig. 222

Schematic illustration of tumour invades beyond the wall of the bile duct to surrounding adipose tissue.

Fig. 223

Schematic illustration of tumour invades adjacent hepatic parenchyma.

Fig. 224

Schematic illustration of tumour invades unilateral branches of the portal vein or hepatic artery.

Fig. 225


N – Regional Lymph Nodes















NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastases to 1 to 3 regional lymph nodes
N2 Metastases to 4 or more regional nodes

M – Distant Metastasis









M0 No distant metastasis
M1 Distant metastasis

TNM Pathological Classification


The pT and pN categories correspond to the T and N categories.






pM1 Distant metastasis microscopically confirmed

Note


pM0 and pMX are not valid categories.






pN0 Histological examination of a regional lymphadenectomy specimen will ordinarily include 15 or more lymph nodes. If the regional lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0.

Summary

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Dec 15, 2022 | Posted by in ONCOLOGY | Comments Off on BILE DUCTS – PERIHILAR (ICD‐O‐3 C24.0)

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