Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

Abstract

Despite a gradual decrease in prevalence, clonorchiasis is still prevalent in East Asia. A large and compelling body of evidence links clonorchiasis and cholangiocarcinoma, although the mechanisms involved are not completely understood. Clonorchiasis induces biliary epithelial hyperplasia and metaplasia, and this could facilitate at least one stage of the carcinogenesis, which is promoting effect. In areas of endemic infection, more clonorchiasis cases are now diagnosed incidentally during radiological examinations such as cholangiography, ultrasonography, and computed tomography. Radiological findings are regarded as pathognomonic for clonorchiasis since they reflect the unique pathological changes of this disorder. These radiological examinations currently play important roles in the diagnosis, staging, and decision-making process involved in the treatment of cholangiocarcinoma. The morphological features and radiological findings of clonorchiasis-associated cholangiocarcinoma are essentially combinations of the findings for the two diseases. The morphological features of clonorchiasis- associated cholangiocarcinoma, observed in radiological examinations, do not differ from those of the usual cholangiocarcinoma. In patients diagnosed with or suspected to have clonorchiasis, radiological findings should be carefully scrutinized for occult cholangiocarcinoma

Synchronous development of HCC and CCC in the same subsegment of the liver in a patient with type C liver cirrhosis

“…However, the echo patterns are diverse and non-specific [43] . Dynamic CT and magnetic resonance imaging (MRI) reveal rim-like or band-like peripheral contrast enhancement of variable thickness around the tumor during the early phase, with progressive and concentric filling of the contrast material at a later phase [44] . CCCs appear hypointense on T1-weighted images and hyperintense on T2-weighted images [45,46] .…”

Cholangiocarcinoma of intrahepatic bile ducts with disseminated metastases in a Siamese cat: a case report

“…CC may be caused by the trematode Clonorchis sinensis; exposure to o-aminoazotoluene and sulphite compounds used as insecticides for a long time in cats and humans; bile stones; and sclerosing cholangitis in humans (Hou 1964;Hammer and Sikkema 1995;Thamm 2001;Cullen and Poop 2002;Choi et al 2004). Clonorchis sinensis was not detected in this study.…”

“…However, it has been associated with Clonorchis sinensis, a trematode frequently found in natural and experimental cases in cats and humans in southeast Asia (Hou 1964;Thamm 2001;Choi et al 2004). In addition, prolonged exposure to o-aminoazotoluene and aramite, a sulphur-containing compound used for insecticide purposes, may cause CC (Cullen and Poop 2002).…”

Commonly Employed Tropical Surgeries

“…In stones of gall bladder and common bile duct, exploration of the involved structures with repeated washouts may be needed. This should be followed by choledochoduodenostomy and Roux loop (access loop) technique [6].…”