title: Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation.
abstract: Intrahepatic cholangiocarcinoma is the second most common primary hepatic tumor. Various risk factors have been reported for intrahepatic cholangiocarcinoma, and the radiologic and pathologic findings of this disease entity may differ depending on the underlying risk factors. Intrahepatic cholangiocarcinoma can be classified into three types on the basis of gross morphologic features: mass-forming (the most common), periductal infiltrating, and intraductal growth. At computed tomography (CT), mass-forming intrahepatic cholangiocarcinoma usually appears as a homogeneous low-attenuation mass with irregular peripheral enhancement and can be accompanied by capsular retraction, satellite nodules, and peripheral intrahepatic duct dilatation. Periductal infiltrating cholangiocarcinoma is characterized by growth along the dilated or narrowed bile duct without mass formation. At CT and magnetic resonance imaging, diffuse periductal thickening and increased enhancement can be seen with a dilated or irregularly narrowed intrahepatic duct. Intraductal cholangiocarcinoma may manifest with various imaging patterns, including diffuse and marked ductectasia either with or without a grossly visible papillary mass, an intraductal polypoid mass within localized ductal dilatation, intraductal castlike lesions within a mildly dilated duct, and a focal stricture-like lesion with mild proximal ductal dilatation. Awareness of the underlying risk factors and morphologic characteristics of intrahepatic cholangiocarcinoma is important for accurate diagnosis and for differentiation from other hepatic tumorous and nontumorous lesions.
authors.affiliation: Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: Yong Eun
authors.initials: YE
authors.lastname: Chung
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Ju Yeon
authors.initials: JY
authors.lastname: Pyo
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Hyeon Je
authors.initials: HJ
authors.lastname: Cho
authors.forename: Kyung Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Choi
mesh_terms: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology; D018281:Cholangiocarcinoma / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015209:Cholangitis, Sclerosing / Q000150:complications; D015529:Choledochal Cyst / Q000150:complications; D003003:Clonorchiasis / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D012307:Risk Factors; D036542:Tomography, Spiral Computed