IgA class reticulin antibodies of human subtype in gluten sensitive enteropathy.

Epithelial dysplasia is frequently seen adjacent to cholangiocarcinoma in the intra' and extrahepatic bile ducts' and carcinoma of the gall bladder which has a similar epithelial lining.' Extensive severe epithelial dysplasia involving the gall bladder, cystic duct, and common bile duct, associated with adenocarcinoma of the common hepatic duct, was recently reported in a patient with primary sclerosing cholangitis and chronic ulcerative colitis,' diseases which, like Caroli's disease,' are associated with an increased risk of cholangiocarcinoma. These findings, and that of epithelial dysplasia unassociated with carcinoma in Caroli's disease, provide evidence of the premalignant nature of biliary epithelial dysplasia. Because such dysplasia is usually detected only in surgical specimens, we agree that early resection of localised forms of Caroli's disease may be necessary to prevent late complication by cholangiocarcinoma.'