Biliary cystadenoma and cystadenocarcinoma CT: Difference between revisions
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Abdominal ultrasound and CT scan are considered the most useful radiologic studies, allowing correct diagnosis in most cases. In particular, CT scan usually shows a multiloculated cyst, whose wall is rarely calcified. The presence of intraluminal polypoid projections originating from the wall should raise the suspicion for cystadenocarcinoma. However, imaging studies are not sensitive enough to safely exclude the presence of malignant degeneration of cystadenoma. Magnetic resonance imaging (MRI) can provide additional informations on the nature of the cystic fluid (i.e., serous vs. mucinous vs. hemorrhagic). Endoscopic retrograde cholangiopancreatography (ERCP), even if rarely employed, may show a cystic cavity communicating with the biliary tree.<ref name="RamacciatoNigri2006">{{cite journal|last1=Ramacciato|first1=Giovanni|last2=Nigri|first2=Giuseppe R|last3=D'Angelo|first3=Francesco|last4=Aurello|first4=Paolo|last5=Bellagamba|first5=Riccardo|last6=Colarossi|first6=Cristina|last7=Pilozzi|first7=Emanuela|last8=Del Gaudio|first8=Massimo|journal=World Journal of Surgical Oncology|volume=4|issue=1|year=2006|pages=76|issn=14777819|doi=10.1186/1477-7819-4-76}}</ref> | Abdominal ultrasound and CT scan are considered the most useful radiologic studies, allowing correct diagnosis in most cases. In particular, CT scan usually shows a multiloculated cyst, whose wall is rarely calcified. The presence of intraluminal polypoid projections originating from the wall should raise the suspicion for cystadenocarcinoma. However, imaging studies are not sensitive enough to safely exclude the presence of malignant degeneration of cystadenoma. Magnetic resonance imaging (MRI) can provide additional informations on the nature of the cystic fluid (i.e., serous vs. mucinous vs. hemorrhagic). Endoscopic retrograde cholangiopancreatography (ERCP), even if rarely employed, may show a cystic cavity communicating with the biliary tree.<ref name="RamacciatoNigri2006">{{cite journal|last1=Ramacciato|first1=Giovanni|last2=Nigri|first2=Giuseppe R|last3=D'Angelo|first3=Francesco|last4=Aurello|first4=Paolo|last5=Bellagamba|first5=Riccardo|last6=Colarossi|first6=Cristina|last7=Pilozzi|first7=Emanuela|last8=Del Gaudio|first8=Massimo|journal=World Journal of Surgical Oncology|volume=4|issue=1|year=2006|pages=76|issn=14777819|doi=10.1186/1477-7819-4-76}}</ref> | ||
Biliary cystadenomas often are diagnosed incidentally, during imaging studies such as ultrasound or CT scan. | |||
==References== | ==References== |
Revision as of 20:02, 17 November 2015
Biliary cystadenoma and cystadenocarcinoma Microchapters |
Differentiating Biliary cystadenoma and cystadenocarcinoma from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
CT
There are no specific imaging features that permit reliable differentiation of biliary cystadenoma from cystadenocarcinoma.
- The CT attenuation of the fluid component in a biliary cystadenoma varies depending on the fluid content.
- Higher attenuation may indicate recent hemorrhage.
- Calcifications that may be present in the septa or cyst wall are typically more apparent with CT than other imaging modalities.
- Septa may enhance with contrast material.
(Images courtesy of RadsWiki)
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CT image demonstates a biliary cystadenoma
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CT image demonstates a biliary cystadenoma
Biliary cystadenomas range in size from 3 to 40 cm, and can be either unilocular or multilocular. Unfortunately there are no specific imaging features that permit reliable differentiation of biliary cystadenoma from biliary cystadenocarcinoma.[1] As is the case with ultrasound, the appearance of the cyst fluid on CT is variable depending on its composition. It can range from that of water (HU = 0) to quite hyperattenuating if the cyst has been complicated by recent hemorrhage.
Calcifications of septa or cyst wall may be seen. Additionally the septa may enhance following administration of contrast. Hypervascularity of mural nodules on CT also suggests malignancy.[2]
Abdominal ultrasound and CT scan are considered the most useful radiologic studies, allowing correct diagnosis in most cases. In particular, CT scan usually shows a multiloculated cyst, whose wall is rarely calcified. The presence of intraluminal polypoid projections originating from the wall should raise the suspicion for cystadenocarcinoma. However, imaging studies are not sensitive enough to safely exclude the presence of malignant degeneration of cystadenoma. Magnetic resonance imaging (MRI) can provide additional informations on the nature of the cystic fluid (i.e., serous vs. mucinous vs. hemorrhagic). Endoscopic retrograde cholangiopancreatography (ERCP), even if rarely employed, may show a cystic cavity communicating with the biliary tree.[3] Biliary cystadenomas often are diagnosed incidentally, during imaging studies such as ultrasound or CT scan.
References
- ↑ Biliary cystadenoma.Dr Yuranga Weerakkody and Radswiki et al.Radiopaedia.org 2015. http://radiopaedia.org/articles/biliary-cystadenoma
- ↑ Ahanatha Pillai, Sastha; Velayutham, Vimalraj; Perumal, Senthilkumar; Ulagendra Perumal, Srinivasan; Lakshmanan, Anand; Ramaswami, Sukumar; Ramasamy, Ravi; Sathyanesan, Jeswanth; Palaniappan, Ravichandran; Rajagopal, Surendran (2012). "Biliary Cystadenomas: A Case for Complete Resection". HPB Surgery. 2012: 1–6. doi:10.1155/2012/501705. ISSN 0894-8569.
- ↑ Ramacciato, Giovanni; Nigri, Giuseppe R; D'Angelo, Francesco; Aurello, Paolo; Bellagamba, Riccardo; Colarossi, Cristina; Pilozzi, Emanuela; Del Gaudio, Massimo (2006). World Journal of Surgical Oncology. 4 (1): 76. doi:10.1186/1477-7819-4-76. ISSN 1477-7819. Missing or empty
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