J Korean Radiol Soc.  1986 Aug;22(4):518-525. 10.3348/jkrs.1986.22.4.518.

Computed tomographic findings of intrahepatic peripheral cholangiocarcinoma

• Woo SK
• Suh SJ
• Kim HJ
• Chun BH

• KMID: 2462314
• DOI: http://doi.org/10.3348/jkrs.1986.22.4.518

Abstract

Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bileduct(peripheral type), a major intrahepatic duct including the hepatic hilus, an extrahepatic duct, or near thepapilla of Vater(central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of theliver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiateon the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinomaof the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male,and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases,abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Labratory findings were not specific, but therewere only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case,intrahepatic duct stones, in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis fromhepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4cases. 8. Common CT features of the intrahepatic peripheral cholangiocarcinoma of the liver were irregular,inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompained by diffuse orsegmental dilatation of the intrahepatic bile duct. If there were normal alphafetoprotein level, positive skinand/or stool examination for CS and difuse or segmental dilatation of the intrahepatic duct in low density livertumor on the CT, one should consider peripheral cholangiocarcinoma of the liver than hepatoma.

MeSH Terms

alpha-Fetoproteins
Bile Ducts
Bile Ducts, Intrahepatic
Biopsy, Needle
Carcinoma, Hepatocellular
Cholangiocarcinoma*
Cholecystitis
Diagnosis
Diagnosis, Differential
Dilatation
Female
Gallstones
Humans
Liver
Neoplasm Metastasis
Ultrasonography
alpha-Fetoproteins