Differentiating cholangiocarcinoma from other diseases: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Dildar Hussain (talk | contribs)
nocaptcha
2,304 edits
No edit summary
Dildar Hussain (talk | contribs)
nocaptcha
2,304 edits
Line 46: Line 46:
'''Abbreviations:'''
'''Abbreviations:'''
'''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''IV'''= Intravenous, '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CXR'''= Chest X ray, '''IgA'''= [[Immunoglobulin A]], '''IgG'''= [[Immunoglobulin G]], '''IgM'''= [[Immunoglobulin M]], '''CT'''= [[Computed tomography]], '''[[PMN]]'''= Polymorphonuclear cells, '''[[ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[CRP]]'''= [[C-reactive protein]], TS= [[Transferrin saturation]], SF= Serum [[Ferritin]], SMA= [[Superior mesenteric artery]], SMV= [[Superior mesenteric vein]], ECG= [[Electrocardiogram]]
'''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LUQ'''= Left upper quadrant, '''LLQ'''= Left lower quadrant, '''RLQ'''= Right lower quadrant, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''IV'''= Intravenous, '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CXR'''= Chest X ray, '''IgA'''= [[Immunoglobulin A]], '''IgG'''= [[Immunoglobulin G]], '''IgM'''= [[Immunoglobulin M]], '''CT'''= [[Computed tomography]], '''[[PMN]]'''= Polymorphonuclear cells, '''[[ESR]]'''= [[Erythrocyte sedimentation rate]], '''[[CRP]]'''= [[C-reactive protein]], TS= [[Transferrin saturation]], SF= Serum [[Ferritin]], SMA= [[Superior mesenteric artery]], SMV= [[Superior mesenteric vein]], ECG= [[Electrocardiogram]]


{| class="wikitable" style="border: 0px; font-size: 90%; margin: 5px;" align="center"
{| class="wikitable" style="border: 0px; font-size: 90%; margin: 5px;" align="center"
Line 91: Line 90:
* Elevated [[CA-19-9|CA 19-9]]
* Elevated [[CA-19-9|CA 19-9]]
* Increased [[amylase]] / [[lipase]]
* Increased [[amylase]] / [[lipase]]
* Increased stool fat content
* Increased [[Steatorrhea|stool fat]] content
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Contrast-enhanced ultrasound  
*[[Contrast-enhanced ultrasound]]
*CT scan
*[[Computed tomography|CT scan]]
**Calcification
**[[Calcification]]
**Pseudocyst  
**[[Pseudocyst]]
**Dilation of main pancreatic duct
**Dilation of main pancreatic duct
*MRI
*[[Magnetic resonance imaging|MRI]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Predisposes to pancreatic cancer
* Predisposes to pancreatic cancer
Line 123: Line 122:
*[[Thrombocytopenia]]
*[[Thrombocytopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* US
* [[Ultrasound|US]]
* CT
* [[Computed tomography|CT]]
* MRI
* [[MRI]]
* Liver biopsy
* [[Liver biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
Other symptoms:
Other symptoms:
Line 183: Line 182:
* Normal AFP
* Normal AFP
*Minor elevations of
*Minor elevations of
**Aspartate  
**[[Aspartate]]
**Alanine aminotransferase
**[[Alanine aminotransferase]]
**Alkaline phosphatase
**[[Alkaline phosphatase]]
**Gamma glutamyl transpeptidase  
**[[Gamma glutamyl transpeptidase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Us
* Us
* Multiphasic helical CT scan  
* Multiphasic [[helical CT scan]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Open biopsy if diagnosis can not be established
* Open [[biopsy]] if diagnosis can not be established
|-
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
Line 230: Line 229:
* ↑ [[CA-19-9|CA 19-9]]
* ↑ [[CA-19-9|CA 19-9]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* US
* [[Ultrasonography|US]]
* CT
* CT
* MRI
* MRI
Line 329: Line 328:
* [[Thrombocytopenia]]
* [[Thrombocytopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |US
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |US
* Nodular,shrunken liver or coarse liver
* Nodular,shrunken or coarse liver
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Stigmata of liver disease
* Stigmata of liver disease

Revision as of 15:10, 2 February 2018

Cholangiocarcinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cholangiocarcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Differentiating cholangiocarcinoma from other diseases On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Differentiating cholangiocarcinoma from other diseases

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Differentiating cholangiocarcinoma from other diseases

CDC on Differentiating cholangiocarcinoma from other diseases

Differentiating cholangiocarcinoma from other diseases in the news

Blogs on Differentiating cholangiocarcinoma from other diseases

Directions to Hospitals Treating Cholangiocarcinoma

Risk calculators and risk factors for Differentiating cholangiocarcinoma from other diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]

Overview

Cholangiocarcinoma must be differentiated from other diseases that cause jaundice, abdominal pain, weight loss, and fatigue, such as gallbladder cancer, hepatocellular carcinoma, pancreatic cancer, cholecystitis, and choledochitis.

Differentiating cholangiocarcinoma from other diseases

Cholangiocarcinoma must be differentiated from other diseases that cause jaundice, abdominal pain, weight loss, and fatigue, such as:

Cholangiocarcinoma must be differentiated from other diseases such as:[1]

Intrahepatic mass-forming cholangiocarcinoma must be differentiated from:

  • Liver metastases
  • Central necrosis (high T2 signal) is more common
  • Hepatocellular carcinoma (HCC)
  • Tumor thrombus more common
  • Capsular retraction uncommon
  • May appear very similar
  • Other primary liver tumors
  • Hepatic abscess

Periductal infiltrating cholangiocarcinoma must be differentiated from:

  • Benign stricture
  • Usually short-segment
  • Regular margin
  • Symmetric narrowing
  • No ductal enhancement
  • No lymph node enlargement
  • No periductal soft-tissue mass
  • Periportal lymphangitic metastasis

Intraductal cholangiocarcinoma must be differentiated from:

  • Intraductal invasion by a HCC
  • Extraductal mass
  • Hepatolithiasis
  • No enhancement
  • Higher attenuation
  • Biliary cystadenoma or cystadenocarcinoma
  • Intratumoural cysts do not communicate with the biliary tree
  • Benign stricture

Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram

Disease Clinical manifestations Diagnosis Comments
Symptoms Signs
Abdominal Pain Fever Rigors and chills Nausea or vomiting Jaundice Constipation Diarrhea Weight loss GI bleeding Hypo-

tension

Guarding Rebound Tenderness Bowel sounds Lab Findings Imaging
Cholangiocarcinoma RUQ + − + + − − + − − − + Normal
  • Predisposes to pancreatic cancer
Hepatocellular carcinoma/Metastasis RUQ + − + + + + + + + − +
  • Normal
  • Hyperactive if obstruction present

Other symptoms:

Pancreatic carcinoma MidEpigastric − − + + + − + − − − + Normal

Skin manifestations may include:

Focal nodular hyperplasia Diffuse ± − − ± − − + + − − − Normal
  • Open biopsy if diagnosis can not be established
Disease Abdominal Pain Fever Rigors and chills Nausea or vomiting Jaundice Constipation Diarrhea Weight loss GI bleeding Hypo-

tension

Guarding Rebound Tenderness Bowel sounds Lab Findings Imaging Comments
Gallbladder cancer Midepigastric − − + + − + + − − − − Normal
Liver hemangioma Intermittent RUQ − − + + − − − − − − − Normal
  • Abnormal LFTs
Liver abscess RUQ + − + + − − + − − − − Normal
  • US
  • CT
Cirrhosis RUQ+Bloating + − + + − − + − − − − Normal US
  • Stigmata of liver disease
  • Cruveilhier- Baumgarten murmur
Inflammatory lesions RUQ ± − + + − − − − − − − Normal US
  • Nodular,shrunken or coarse liver
  • Stigmata of liver disease

References

  1. ↑ Cholangiocarcinoma. Radiopaedia. http://radiopaedia.org/articles/cholangiocarcinoma

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Differentiating_cholangiocarcinoma_from_other_diseases&oldid=1437089"