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Fifty autopsy cases (35 male and 15 female) of mucin-secreting cholangiocarcinoma in Chinese were reviewed. The peak incidence was in the 7th decade for males and in the 6th for females. Massive (37), multinodular (8), diffuse (1) and hilar (4) types were recognized grossly. The hilar tumours arose from the main intrahepatic ducts and the other types originated from smaller ducts. The overall association with stones was 20% and clonorchiasis 92%. Cirrhosis occurred in only 4% of cases. There was an association between the degree of mucin secretion and the presence and severity of clonorchiasis.

Histochemical studies of mucins were carried out on 17 autopsy specimens of cholangiocarcinomas associated with clonorchiasis. All tumours produced epithelial mucins which were mixtures of neutral and acid mucopolysaccharides without any histochemically demonstrable components of sialic and uronic acids. The mucins were qualitatively similar to that secreted by normal and Clonorchis-infested bile ducts. However carboxymucins were reduced and sulphomucins were absent or present only in trace amounts in the neoplastic epithelium; in the hyperplastic epithelium in clonorchiasis sulphomucins were abundant. The HID-AB technique for sulphomucins is valuable in differentiating hyperplastic bile ducts and cholangiocarcinoma.