Asbestos has been implicated as a cause for cholangiocarcinoma as well as pleural and peritoneal mesotheliomas.
Patient selection: cholangiocarcinoma
Theoretical mechanism: absorption of asbestos fibers from GI tract with enterohepatic circulation through the biliary system
Source of asbestos: most likely water but also food and swallowed dust
Evidence for the diagnosis
(1) identification of a source of asbestos exposure
(2) demonstration of asbestos fibers in histologic sections and/or electron microscopy
(3) demonstration of asbestos fibers in digest of the tumor
(4) exclusion of a more plausible cause
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Specialty: Hematology Oncology, Toxicology
