A 55-year-old man who migrated from southern China gives a history of eating raw freshwater carp. He has recurrent episodes of right upper quadrant pain and jaundice. Ultrasound shows dilatation of the intrahepatic bile ducts, and stool examination reveals small operculated flask shaped eggs. Which malignancy is this infection classically associated with?
- A Gallbladder adenocarcinoma
- B Hepatocellular carcinoma
- C Cholangiocarcinoma ✓
- D Adenocarcinoma of the ampulla of Vater
Correct answer: C. Cholangiocarcinoma
Explanation
Clonorchis sinensis adults inhabit the intrahepatic biliary radicles after humans ingest metacercariae encysted in raw freshwater fish. Chronic irritation, periductal fibrosis, and proliferation of ductal epithelium predispose to cholangiocarcinoma. Hepatocellular carcinoma is linked to hepatitis B and A viruses and aflatoxin rather than to liver flukes, and there is no established association of clonorchiasis with gallbladder or ampullary tumours, which removes those options.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.