A camouflaging mystery: solid-tubulocystic variant of intrahepatic cholangiocarcinoma
[Display omitted] •Solid-tubulocystic variant of iCCA presents in young patients without risk factors.•This variant exhibits NIPBL-NACC1 gene fusion with distinct biphasic histology.•Inhibin and synaptophysin may lead to misdiagnosis as neuroendocrine tumor.•Limited immunotherapy response despite hi...
Uloženo v:
| Vydáno v: | Human Pathology Reports Ročník 42; s. 300797 |
|---|---|
| Hlavní autoři: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Elsevier Inc
01.11.2025
Elsevier |
| Témata: | |
| ISSN: | 2772-736X, 2772-736X |
| On-line přístup: | Získat plný text |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | [Display omitted]
•Solid-tubulocystic variant of iCCA presents in young patients without risk factors.•This variant exhibits NIPBL-NACC1 gene fusion with distinct biphasic histology.•Inhibin and synaptophysin may lead to misdiagnosis as neuroendocrine tumor.•Limited immunotherapy response despite high TMB; PD-L1 and MSI-H are not predictive.•Molecular testing in rare iCCA variants is crucial to avoid diagnostic pitfalls.
Cholangiocarcinoma is a rare and aggressive malignancy with a rising incidence in recent years. Known risk factors include cirrhosis, alcohol use, smoking history, family history of bile duct cancer, male gender, and hepatitis B and/or C. The solid-tubulocystic variant of intrahepatic cholangiocarcinoma, previously named cholangioblastic variant, is an even rarer form with only several cases reported in literature to date. Interestingly, this variant is not associated with the same risk factors as typical cholangiocarcinoma, often diagnosed in young, previously healthy females. Given its rarity, diagnosis is often delayed and optimal treatment is unknown, leading to poor prognosis. Here, we discuss the case of an 18-year-old female admitted to our hospital with solid-tubulocystic variant of cholangiocarcinoma, in which molecular analysis confirmed the presence of a characteristic NIPBL-NACC1 gene rearrangement, and our management. |
|---|---|
| AbstractList | [Display omitted]
•Solid-tubulocystic variant of iCCA presents in young patients without risk factors.•This variant exhibits NIPBL-NACC1 gene fusion with distinct biphasic histology.•Inhibin and synaptophysin may lead to misdiagnosis as neuroendocrine tumor.•Limited immunotherapy response despite high TMB; PD-L1 and MSI-H are not predictive.•Molecular testing in rare iCCA variants is crucial to avoid diagnostic pitfalls.
Cholangiocarcinoma is a rare and aggressive malignancy with a rising incidence in recent years. Known risk factors include cirrhosis, alcohol use, smoking history, family history of bile duct cancer, male gender, and hepatitis B and/or C. The solid-tubulocystic variant of intrahepatic cholangiocarcinoma, previously named cholangioblastic variant, is an even rarer form with only several cases reported in literature to date. Interestingly, this variant is not associated with the same risk factors as typical cholangiocarcinoma, often diagnosed in young, previously healthy females. Given its rarity, diagnosis is often delayed and optimal treatment is unknown, leading to poor prognosis. Here, we discuss the case of an 18-year-old female admitted to our hospital with solid-tubulocystic variant of cholangiocarcinoma, in which molecular analysis confirmed the presence of a characteristic NIPBL-NACC1 gene rearrangement, and our management. Cholangiocarcinoma is a rare and aggressive malignancy with a rising incidence in recent years. Known risk factors include cirrhosis, alcohol use, smoking history, family history of bile duct cancer, male gender, and hepatitis B and/or C. The solid-tubulocystic variant of intrahepatic cholangiocarcinoma, previously named cholangioblastic variant, is an even rarer form with only several cases reported in literature to date. Interestingly, this variant is not associated with the same risk factors as typical cholangiocarcinoma, often diagnosed in young, previously healthy females. Given its rarity, diagnosis is often delayed and optimal treatment is unknown, leading to poor prognosis. Here, we discuss the case of an 18-year-old female admitted to our hospital with solid-tubulocystic variant of cholangiocarcinoma, in which molecular analysis confirmed the presence of a characteristic NIPBL-NACC1 gene rearrangement, and our management. Graphical abstract |
| ArticleNumber | 300797 |
| Author | Afsari, Ali Valerin, Jennifer Kroening, Gianna Jutric, Zeljka Attarian, Shirin Hasan, Nazmul Han, John Zhang, Shannon |
| Author_xml | – sequence: 1 givenname: Shannon surname: Zhang fullname: Zhang, Shannon organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 2 givenname: Nazmul orcidid: 0009-0009-5467-7491 surname: Hasan fullname: Hasan, Nazmul email: nhasan1@hs.uci.edu organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 3 givenname: John surname: Han fullname: Han, John organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 4 givenname: Gianna surname: Kroening fullname: Kroening, Gianna organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 5 givenname: Zeljka surname: Jutric fullname: Jutric, Zeljka organization: University of California Irvine, Department of Hepatobiliary and Pancreas Surgery, 101 The City Drive South, Orange, CA 92868, United States – sequence: 6 givenname: Ali surname: Afsari fullname: Afsari, Ali organization: University of California Irvine, Department of Pathology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 7 givenname: Shirin surname: Attarian fullname: Attarian, Shirin organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States – sequence: 8 givenname: Jennifer surname: Valerin fullname: Valerin, Jennifer organization: University of California Irvine, Division of Hematology/Oncology, 101 The City Drive South, Orange, CA 92868, United States |
| BookMark | eNqFkd2KFDEQhYOs4LruA3jXL9BjfjqdjoKwLP4sLHihC96FSroyk7YnGZKehXl7046ICOpVhQPnq8o5z8lFTBEJecnohlHWv5o2u0PecMrlRlCqtHpCLrlSvFWi_3rx2_sZuS5lopTygVE6sEvycNM42Kejn2Eb4rbZn8qC-fS6KWkOY7sc7XFOrorBNY-QA8SlSb4JccmwwwOsutulGeI2JAfZhZj28II89TAXvP45r8jD-3dfbj-2958-3N3e3Leu6-XSWvBMaxQ9DMr5Tow9as-FsFIM2vKOD1pxqcFZPXra8d76TlrJ7cis9GIQV-TuzB0TTOaQwx7yySQI5oeQ8tZArifOaHr0rAMFcvCqU15qIQfEDsABH5WDymJnlsuplIz-F49Rs8ZsJlNjNmvM5hxz9bw5e7B-8jFgNsUFjA7HkNEt9YrwT_fbP9xuDjE4mL_hCcuUjjnW9AwzhRtqPq81ri1yuTaoZQXovwP-s_w7HuaxHQ |
| Cites_doi | 10.14309/crj.0000000000000746 10.1055/s-0041-1730889 10.1016/j.humpath.2021.07.004 10.1159/000453013 10.1016/j.bpg.2015.02.003 10.4254/wjh.v15.i7.897 10.1001/jamaoncol.2021.3836 10.1016/S1470-2045(20)30321-1 10.1056/NEJMoa2206834 10.1016/S1665-2681(19)31427-9 10.1016/j.humpath.2017.02.001 |
| ContentType | Journal Article |
| Copyright | 2025 The Author(s) The Author(s) |
| Copyright_xml | – notice: 2025 The Author(s) – notice: The Author(s) |
| DBID | 6I. AAFTH AAYXX CITATION DOA |
| DOI | 10.1016/j.hpr.2025.300797 |
| DatabaseName | ScienceDirect Open Access Titles Elsevier:ScienceDirect:Open Access CrossRef DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef |
| DatabaseTitleList | |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2772-736X |
| EndPage | 300797 |
| ExternalDocumentID | oai_doaj_org_article_6ef14a7a58f747f59358ee4aaca2d7ca 10_1016_j_hpr_2025_300797 S2772736X25000295 1_s2_0_S2772736X25000295 |
| GroupedDBID | .1- .FO 0R~ AALRI AAXUO AAYWO ACVFH ADCNI ADVLN AEUPX AFJKZ AFPUW AFRHN AIGII AITUG AJUYK AKBMS AKYEP ALMA_UNASSIGNED_HOLDINGS AMRAJ APXCP EBS FDB GROUPED_DOAJ M41 M~E NQS OK1 ROL Z5R 6I. AAFTH AAYXX CITATION |
| ID | FETCH-LOGICAL-c465t-baf199e36a87cf43d6e9f233b5389b242897259acb9df0426bf45b52bd1b5f383 |
| IEDL.DBID | DOA |
| ISICitedReferencesCount | 0 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001587452400001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 2772-736X |
| IngestDate | Tue Oct 07 09:28:27 EDT 2025 Thu Nov 20 00:56:19 EST 2025 Sat Nov 01 16:52:37 EDT 2025 Sat Nov 29 12:11:23 EST 2025 Sat Nov 01 15:01:40 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Keywords | NIPBL Tubulocystic Fusion Cholangiocarcinoma NACC1 |
| Language | English |
| License | This is an open access article under the CC BY license. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c465t-baf199e36a87cf43d6e9f233b5389b242897259acb9df0426bf45b52bd1b5f383 |
| ORCID | 0009-0009-5467-7491 |
| OpenAccessLink | https://doaj.org/article/6ef14a7a58f747f59358ee4aaca2d7ca |
| PageCount | 1 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_6ef14a7a58f747f59358ee4aaca2d7ca crossref_primary_10_1016_j_hpr_2025_300797 elsevier_sciencedirect_doi_10_1016_j_hpr_2025_300797 elsevier_clinicalkeyesjournals_1_s2_0_S2772736X25000295 elsevier_clinicalkey_doi_10_1016_j_hpr_2025_300797 |
| PublicationCentury | 2000 |
| PublicationDate | 2025-11-01 |
| PublicationDateYYYYMMDD | 2025-11-01 |
| PublicationDate_xml | – month: 11 year: 2025 text: 2025-11-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationTitle | Human Pathology Reports |
| PublicationYear | 2025 |
| Publisher | Elsevier Inc Elsevier |
| Publisher_xml | – name: Elsevier Inc – name: Elsevier |
| References | Kirstein, Vogel (b0005) 2016; 32 Zhu, Macarulla, Javle (b0025) 2021; 7 Goyal, Meric-Bernstam, Hollebecque (b0030) 2023; 388 Oh, He, Qin (b0020) 2022; 1 Subbiah, Lassen, Elez (b0040) 2020; 21 Verhoeff, Bacani, Fung (b0050) 2022; 9 Bergquist, von Seth (b0015) 2015; 29 González, Luo, Zhang (b0065) 2023; 15 Haaft, Pedregal, Prato (b0035) 2024; 199 Argani, Palsgrove, Anders (b0055) 2022 Wen, Joseph, Srivastava (b0070) 2021; 116 Vijayaraghavan, Rakesh, Latha (b0010) 2022; 11 Chablé-Montero, Shah, Montante-Montes de Oca (b0060) 2012; 11 Braxton, Saxe, Damjanov (b0045) 2017; 62 Bergquist (10.1016/j.hpr.2025.300797_b0015) 2015; 29 Zhu (10.1016/j.hpr.2025.300797_b0025) 2021; 7 Argani (10.1016/j.hpr.2025.300797_b0055) 2022 Haaft (10.1016/j.hpr.2025.300797_b0035) 2024; 199 Verhoeff (10.1016/j.hpr.2025.300797_b0050) 2022; 9 Oh (10.1016/j.hpr.2025.300797_b0020) 2022; 1 Goyal (10.1016/j.hpr.2025.300797_b0030) 2023; 388 Subbiah (10.1016/j.hpr.2025.300797_b0040) 2020; 21 González (10.1016/j.hpr.2025.300797_b0065) 2023; 15 Kirstein (10.1016/j.hpr.2025.300797_b0005) 2016; 32 Vijayaraghavan (10.1016/j.hpr.2025.300797_b0010) 2022; 11 Braxton (10.1016/j.hpr.2025.300797_b0045) 2017; 62 Chablé-Montero (10.1016/j.hpr.2025.300797_b0060) 2012; 11 Wen (10.1016/j.hpr.2025.300797_b0070) 2021; 116 |
| References_xml | – volume: 15 start-page: 897 year: 2023 end-page: 903 ident: b0065 article-title: Solid-tubulocystic carcinoma: a new variant of intrahepatic cholangiocarcinoma publication-title: World J. Hepatol. – volume: 9 year: 2022 ident: b0050 article-title: A cholangioblastic variant of cholangiocarcinoma publication-title: ACG Case Rep. J. – volume: 11 start-page: 961 year: 2012 end-page: 965 ident: b0060 article-title: Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular, and insular patterns publication-title: Ann. Hepatol. – volume: 1 year: 2022 ident: b0020 article-title: Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer publication-title: NEJM – volume: 32 start-page: 395 year: 2016 end-page: 400 ident: b0005 article-title: Epidemiology and risk factors for cholangiocarcinoma publication-title: Visc. Med. – volume: 388 year: 2023 ident: b0030 article-title: Futibatinib for FGFR2-rearranged intrahepatic cholangiocarcinoma publication-title: NEJM – volume: 29 start-page: 221 year: 2015 end-page: 232 ident: b0015 article-title: Epidemiology of cholangiocarcinoma publication-title: Best Pract. Res. Clin. Gastroenterol. – volume: 21 start-page: 1234 year: 2020 end-page: 1243 ident: b0040 article-title: Dabrafenib plus trametinib in patients with BRAFV600E-Mutated Biliary Tract Cancer (ROAR): a phase 2, open-label, single-arm, multicentre basket trial publication-title: Lancet Oncol. – volume: 7 start-page: 1669 year: 2021 end-page: 1677 ident: b0025 article-title: Final overall survival efficacy results of ivosidenib for patients with advanced cholangiocarcinoma with IDH1 mutation the phase 3 randomized clinical CarIDHY trial publication-title: JAMA Oncol. – volume: 116 start-page: 82 year: 2021 end-page: 93 ident: b0070 article-title: Inhibin-positive hepatic carcinoma: proposal for a solid-tubulocystic variant of intrahepatic cholangiocarcinoma publication-title: Hum. Pathol. – volume: 199 year: 2024 ident: b0035 article-title: Revolutionizing anti-HER2 therapies for extrahepatic cholangiocarcinoma and gallbladder cancer: current advancements and future perspectives publication-title: Eur. J. Cancer – volume: 11 start-page: 36 year: 2022 end-page: 39 ident: b0010 article-title: Treatment outcomes of advanced cholangiocarcinoma: a single-center experience from India publication-title: South Asian J Cancer. – year: 2022 ident: b0055 article-title: A novel NIPBL-NACC1 gene fusion is characteristic of the cholangioblastic variant of intrahepatic cholangiocarcinoma publication-title: Am. J. Surg. Pathol. – volume: 62 start-page: 232 year: 2017 end-page: 241 ident: b0045 article-title: Molecular and cytogenomic profiling of hepatic adenocarcinoma expressing inhibinA, a mimicker of neuroendocrine tumors: proposal to reclassify as “cholangioblastic variant of intrahepatic cholangiocarcinoma. publication-title: Hum. Pathol. – volume: 9 issue: 2 year: 2022 ident: 10.1016/j.hpr.2025.300797_b0050 article-title: A cholangioblastic variant of cholangiocarcinoma publication-title: ACG Case Rep. J. doi: 10.14309/crj.0000000000000746 – volume: 199 year: 2024 ident: 10.1016/j.hpr.2025.300797_b0035 article-title: Revolutionizing anti-HER2 therapies for extrahepatic cholangiocarcinoma and gallbladder cancer: current advancements and future perspectives publication-title: Eur. J. Cancer – volume: 11 start-page: 36 issue: 1 year: 2022 ident: 10.1016/j.hpr.2025.300797_b0010 article-title: Treatment outcomes of advanced cholangiocarcinoma: a single-center experience from India publication-title: South Asian J Cancer. doi: 10.1055/s-0041-1730889 – volume: 116 start-page: 82 year: 2021 ident: 10.1016/j.hpr.2025.300797_b0070 article-title: Inhibin-positive hepatic carcinoma: proposal for a solid-tubulocystic variant of intrahepatic cholangiocarcinoma publication-title: Hum. Pathol. doi: 10.1016/j.humpath.2021.07.004 – volume: 32 start-page: 395 issue: 6 year: 2016 ident: 10.1016/j.hpr.2025.300797_b0005 article-title: Epidemiology and risk factors for cholangiocarcinoma publication-title: Visc. Med. doi: 10.1159/000453013 – volume: 29 start-page: 221 issue: 2 year: 2015 ident: 10.1016/j.hpr.2025.300797_b0015 article-title: Epidemiology of cholangiocarcinoma publication-title: Best Pract. Res. Clin. Gastroenterol. doi: 10.1016/j.bpg.2015.02.003 – volume: 15 start-page: 897 issue: 7 year: 2023 ident: 10.1016/j.hpr.2025.300797_b0065 article-title: Solid-tubulocystic carcinoma: a new variant of intrahepatic cholangiocarcinoma publication-title: World J. Hepatol. doi: 10.4254/wjh.v15.i7.897 – volume: 7 start-page: 1669 issue: 11 year: 2021 ident: 10.1016/j.hpr.2025.300797_b0025 article-title: Final overall survival efficacy results of ivosidenib for patients with advanced cholangiocarcinoma with IDH1 mutation the phase 3 randomized clinical CarIDHY trial publication-title: JAMA Oncol. doi: 10.1001/jamaoncol.2021.3836 – volume: 21 start-page: 1234 issue: 9 year: 2020 ident: 10.1016/j.hpr.2025.300797_b0040 article-title: Dabrafenib plus trametinib in patients with BRAFV600E-Mutated Biliary Tract Cancer (ROAR): a phase 2, open-label, single-arm, multicentre basket trial publication-title: Lancet Oncol. doi: 10.1016/S1470-2045(20)30321-1 – year: 2022 ident: 10.1016/j.hpr.2025.300797_b0055 article-title: A novel NIPBL-NACC1 gene fusion is characteristic of the cholangioblastic variant of intrahepatic cholangiocarcinoma publication-title: Am. J. Surg. Pathol. – volume: 388 issue: 3 year: 2023 ident: 10.1016/j.hpr.2025.300797_b0030 article-title: Futibatinib for FGFR2-rearranged intrahepatic cholangiocarcinoma publication-title: NEJM doi: 10.1056/NEJMoa2206834 – volume: 1 issue: 8 year: 2022 ident: 10.1016/j.hpr.2025.300797_b0020 article-title: Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer publication-title: NEJM – volume: 11 start-page: 961 year: 2012 ident: 10.1016/j.hpr.2025.300797_b0060 article-title: Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular, and insular patterns publication-title: Ann. Hepatol. doi: 10.1016/S1665-2681(19)31427-9 – volume: 62 start-page: 232 year: 2017 ident: 10.1016/j.hpr.2025.300797_b0045 article-title: Molecular and cytogenomic profiling of hepatic adenocarcinoma expressing inhibinA, a mimicker of neuroendocrine tumors: proposal to reclassify as “cholangioblastic variant of intrahepatic cholangiocarcinoma. publication-title: Hum. Pathol. doi: 10.1016/j.humpath.2017.02.001 |
| SSID | ssj0002810081 |
| Score | 2.308288 |
| Snippet | [Display omitted]
•Solid-tubulocystic variant of iCCA presents in young patients without risk factors.•This variant exhibits NIPBL-NACC1 gene fusion with... Graphical abstract Cholangiocarcinoma is a rare and aggressive malignancy with a rising incidence in recent years. Known risk factors include cirrhosis, alcohol use, smoking... |
| SourceID | doaj crossref elsevier |
| SourceType | Open Website Index Database Publisher |
| StartPage | 300797 |
| SubjectTerms | Cholangiocarcinoma Fusion NACC1 NIPBL Pathology Tubulocystic |
| Title | A camouflaging mystery: solid-tubulocystic variant of intrahepatic cholangiocarcinoma |
| URI | https://www.clinicalkey.com/#!/content/1-s2.0-S2772736X25000295 https://www.clinicalkey.es/playcontent/1-s2.0-S2772736X25000295 https://dx.doi.org/10.1016/j.hpr.2025.300797 https://doaj.org/article/6ef14a7a58f747f59358ee4aaca2d7ca |
| Volume | 42 |
| WOSCitedRecordID | wos001587452400001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 2772-736X dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0002810081 issn: 2772-736X databaseCode: DOA dateStart: 20210101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2772-736X dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0002810081 issn: 2772-736X databaseCode: M~E dateStart: 20210101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LS-UwFA4iIrMRX8PccZQsXAlVmyZtMjtHFBcqgg_uLuQ5VsZ75T4EN_72OSdtpQvRjZsuSpO056T5vpPHdwjZ5argIciYcZGHjHNnMiNKlzEH-CSl9zKle7s7ry4v5XCornqpvnBPWCMP3BjuoAwx56YyQkZgvlHgul0I3BhnmK9cokbAenrB1EOaMkLRmrxbxkwbuu6fUP-Tif0CcBFFnnpAlPT6e3jUw5jTVbLSkkN61LzUGlkIo3WyfNEuf2-Q2yPqDMTq8V_KLUQfUYZ58vKbQgeqfTab2zlg0wtKL9NnCILBanQcaY0TuPcB9047moLZ0d8aMGwCtY4fzSa5PT25OT7L2rwImeOlmGXWxFypUJRGVi7ywpdBRVYUFgYvZQFzpaogqjHOKh8xRrKRCyuY9bkVEULS72RxNB6FH4RyU5ZGScEqb7h11govZUASKCMmjRiQvc5I-qmRv9DdvrAHDRbVaFHdWHRA_qAZ3x5E5ep0A_ypW3_qz_w5IKxzgu4Oh8JwBhXVH7VcvVcoTNsfcqpzPWX6UF-zCglbOWSYCIIpMSD8rWTLORou8XGDP7_iU7fIN6yyOdn4iyzOJvOwTZbc86yeTnZSh4brxevJf8W9_dQ |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+camouflaging+mystery%3A+solid-tubulocystic+variant+of+intrahepatic+cholangiocarcinoma&rft.jtitle=Human+Pathology+Reports&rft.au=Zhang%2C+Shannon&rft.au=Hasan%2C+Nazmul&rft.au=Han%2C+John&rft.au=Kroening%2C+Gianna&rft.date=2025-11-01&rft.pub=Elsevier+Inc&rft.issn=2772-736X&rft.eissn=2772-736X&rft.volume=42&rft_id=info:doi/10.1016%2Fj.hpr.2025.300797&rft.externalDocID=S2772736X25000295 |
| thumbnail_m | http://cvtisr.summon.serialssolutions.com/2.0.0/image/custom?url=https%3A%2F%2Fcdn.clinicalkey.com%2Fck-thumbnails%2F2772736X%2Fcov200h.gif |