Hepatocellular carcinoma with tumor thrombus in bile duct: A proposal of new classification according to resectability of primary lesion

Table 3 Pathological characteristics of bile duct tumor thrombi and primary or recurrent hepatocellular carcinoma lesions when bile duct tumor thrombi was diagnosed

No.	Pathological characteristics of primary or recurrent HCC lesion when BDTT was diagnosed							Pathological characteristics of BDTT
	Location	Size in cm	Morphology of tumor		Differentiation	Necrosis	Extrahepatic infiltration	Location	Size incm	Infiltration outward bile duct	Differentiation
			Macroscopic	Microscopic
1	Left lobe	8 × 6 × 6	Fish-meat like	Platelet/nested/papillary	Poor	+	Full thickness of the stomach wall	LIBD	MicroscopicBDTT	No	Poor
2	Cannot be detected	/	/	/	/	/	/	CBD	5.5 × 4 × 2	No	Moderate
31	Cannot be detected	/	/	/	/	/	/	IBD	/	/	/
4	Right lobe	9 × 4 × 9	Fish-meat like	Nodular	Moderate	+	No	LHD/RHD/CHD	5 × 3 × 3	Yes	Moderate
52	Cannot be detected	/	/	/	/	/	/	CBD	6 × 2 × 2	No	Poor
62	Cannot be detected	/	/	/	/	/	/	CBD	3.5 × 3.5 × 2	No	Moderate
7	Right lobe	7 × 4 × 1	Fish-meat like	Large area of necrosis	Moderate	+	No	CBD	3 × 3 × 2	No	Moderate

¹The patient had metastatic hepatocellular carcinoma lesions in the liver, lymph nodes and abdominal cavity so that adjunctive therapy was adopted without surgery.

²No primary or recurrent hepatocellular carcinoma tumors could be detected so that only bile duct tumor thrombi was extracted. BDTT: Bile duct tumor thrombi; CBD: Common bile duct; CHD: Common hepatic duct; HCC: Hepatocellular carcinoma; IBD: Intrahepatic bile duct; LHD: Left hepatic duct; LIBD: Left intrahepatic bile duct; RHD: Right hepatic duct.