Case 58.  Opistorchiasis (45 y-o F)
         
   
Surgical specimen of cholangiocellular carcinoma in northeastern Thailand
   
         
   
Key words :  Opistorchis veverrini, cholangitis, cholangiocellular carcinoma
   
     
 
     
An adult Opistorchis viverrini is seen in a dilated bile duct (HE, low power). A cross section of the fluke around the ventral sucker is shown.   Both sperm-filled testis and the uterus filled with brown-colored, small-sized ova are seen near the excretory duct (HE, high power).
     
 
     
In the noncancerous liver, a few small-sized ova are seen in the periductal tissue, infiltrated by lymphocytes and eosinophils (HE).   Well-differentiated adenocarcinoma of the bile duct (HE). In the endemic area, most residents are infested through eating unheated river fish ultil 2 years of age, and bile duct cancer occurs around the age of 40 years.