Extent Of Local Tumour Spread

Border: pushing/infiltrative. Lymphocytic reaction: prominent/sparse.

Perineural spread is a characteristic and may be present beyond the resection line causing surgical failure.

The TNM classification applies to carcinomas of the extrahepatic bile ducts and those of choledochal cysts.

pTis carcinoma in situ pT1 tumour confined to the bile duct* histologically

*The wall of the bile duct comprises the subepithelial connective tissues and underlying fibromuscular layer.

pT2 tumour invades beyond the wall of the bile duct*

pT3 tumour invades adjacent structures: liver, pancreas, gall bladder and/or unilateral tributaries of the portal vein or hepatic artery pT4 tumour invades any of the following: main portal vein or its tributaries bilaterally, common hepatic artery, or other adjacent structures, e.g. colon, stomach, duodenum, abdominal wall.

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