Metachronous bile duct cancer nine years after resection of gallbladder cancer

Figure 3 Histopathological finding of hilar bile duct cancer. A: Histologic section of the gallbladder shows well-differentiated biliary-type adenocarcinoma infiltrating the entire thickness of the gallbladder wall (HE, × 100); B: None of the tumor cells expressed CA19-9 (immunoperoxidase method, × 100); C: Histologic section of the hepatic duct demonstrates severe epithelial dysplasia of the mucosa in the upper field (arrows) and invasive adenocarcinoma in the lower field (arrow heads) (hematoxylin and eosin, × 100); D: Most of the dysplastic epithelial cells in the upper field (arrows) and some of invasive tumor cells in the lower field express cytoplasmic CA19-9 (arrow heads). An invasive tumor gland is noted in the mid-left field (immunoperoxidase method, × 100).