Intrahepatic cholangiocarcinomas mimicking other lesions

Abstract

Cholangiocarcinomas can be misdiagnosed when they are small and hypervascular. This atypical hypervascular appearance is rare, and may mimic benign liver lesions and other malignant lesions, especially when small. Awareness of the confounding imaging features of these tumors should lead to a more meticulous evaluation of small hypervascular lesions, and may minimize the risk of misdiagnosing early-stage cholangiocarcinomas.

Tumor grade and sex should influence the utilization of portal lymphadenectomy for early stage intrahepatic cholangiocarcinoma

“…While lesions with hallmark malignant features can be resected without further evaluation, smaller lesions are often biopsied for confirmation using tissue examination. 19 In our analysis, we chose only to include patients with T1 and T2 tumors. These smaller, more confined lesions are of particular interest as they offer the greatest diagnostic ambiguity.…”

Dynamic enhancement patterns of small-diameter mass-forming intrahepatic cholangiocarcinomas on contrast-enhanced magnetic resonance imaging

“…The unenhanced MRI findings in our study are in accordance with the conclusions of previous studies. [ 13 – 15 ] However, it was reported that a target sign in a DWI sequence occurred in approximately 75% (24/32) of cases of small ICC, and DWI is believed capable of distinguishing ICC from HCC. [ 13 ] However, in our study, only approximately one third of the cases had the target sign.…”

“…Although it is known that typical ICC has a different appearance than HCC on contrast-enhanced MRI, [ 1 , 7 , 9 ] a certain percentage of ICCs exhibit atypical imaging features, especially those with diameters ≤30 mm. [ 10 , 11 ] Although some scholars have confirmed that ICCs with different diameters have different imaging features, [ 12 – 15 ] the MRI enhancement characteristics of small ICCs with varying diameters remain to be defined.…”

Imaging of Cholangiocarcinoma

“…Following IV contrast administration, CCs follow an enhancement pattern similar to CECT with little tumoral enhancement on arterial phase images followed by delayed enhancement on delayed phase images. [54][55][56][57][58] The presence of satellite nodules confers a poor prognosis and usually renders a patient inoperable. 59,60 Intraductal CC shows a variety of imaging features depending on its growth characteristics and can manifest on MRI as diffuse infiltrating with severe duct ectasia, an intraductal polypoid-like mass with focal duct dilatation, cast-like lesions, or as a focal stricture.…”