Sir.—In the April issue of the Journal (131:442, 1977) Kulkarni and Beatty reported a case of cholangiocarcinoma associated with biliary cirrhosis due to congenital biliary atresia. They also reviewed seven previously reported cases of hepatic tumors in patients with biliary atresia. In their article they describe and illustrate a cholangiocellular and a hepatocellular component in the tumor. Their illustration suggests to me that their cholangiocellular component may have been a poorly differentiated hepatocellular carcinoma. In favor of this interpretation is the trabecular appearance of this tumor, its cytology, and the relative lack of fibrosis.1 This interpretation is of importance since almost all of the previously reported cases of liver tumors in atresia were hepatocellular carcinomas.
Drs Kulkarni and Beatty declined to reply.—Ed.
RUEBNER BH. Cholangiocarcinoma. Am J Dis Child. 1978;132(2):214. doi:10.1001/archpedi.1978.02120270112028