MACROSCOPIC DESCRIPTION: "Unlabelled as to site": Four cores of cream and dark red tissue 10- 14mm. A1. (SK) Biopsy attended and ROSE performed on specimen. Three air dried smears prepared and stained with rapid Romanovsky. Specimen adequate. MICROSCOPIC DESCRIPTION: Sections show cores of focally necrotic tumour composed of small irregular tubular structures in a dense fibrous stroma. The tubules are lined by cuboidal epithelial cells with pleomorphic hyperchromatic nuclei and small nucleoli. Some lumina contain mucin. In immunostains, the cells are CK7+, CK20-, CEA-, CDX-2-.
DIAGNOSIS: Core biopsy of lesion left lobe of liver: Adenocarcinoma; immunophenotype consistent with a cholangiocarcinoma.