title: Cholangiocarcinoma: epidemiology, risk factors, pathogenesis, and diagnosis.
abstract: Cholangiocarcinoma (CCA) is a rare tumor arising from the epithelium of the intrahepatic or the extrahepatic bile ducts. It is rarely diagnosed before 40 years of age except in patients with primary sclerosing cholangitis. CCA is usually clinically silent until the tumor obstructs the bile ducts. Carbohydrate antigen 19-9 is the most commonly used tumor marker, and magnetic resonance cholangiopancreatography is the best available imaging modality for CCA. Endoscopic retrograde cholangiopancreatography and cholangioscopy allow tissue acquisition. Positron emission tomography may play a role in identifying occult metastases. Tissue diagnosis is obtained by brush cytology or bile duct biopsy.
authors.affiliation: Division of Gastroenterology, Georgetown University Hospital, Second Floor, Main Hospital, M2025, 3800 Reservoir Road NW, Washington, DC 20007, USA. halimcharbel@hotmail.com
authors.forename: Halim
authors.initials: H
authors.lastname: Charbel
authors.forename: Firas H
authors.initials: FH
authors.lastname: Al-Kawas
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D044963:Biopsy, Fine-Needle; D018395:CA-19-9 Antigen / Q000032:analysis; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D019160:Endosonography; D006801:Humans; D049268:Positron-Emission Tomography; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D018395:CA-19-9 Antigen