Differentiating cholangiocarcinoma from other diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Diseases with similar symptoms

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

• Gallbladder cancer

• Hepatocellular Carcinoma

• Pancreatic cancer

• Cholecystitis and choledochitis

• Liver fluke infections

Cholangiocarcinoma must be differentiated from other diseases such as: For an intrahepatic mass-forming cholangiocarcinoma consider:

• 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

For a periductal infiltrating cholangiocarcinoma consider:

• Benign stricture

• Usually short-segment
• Regular margin
• Symmetric narrowing
• No ductal enhancement
• No lymph node enlargement
• No periductal soft-tissue mass

• Periportal lymphangitic metastasis

For an intraductal cholangiocarcinoma consider:

• 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

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

• Gallbladder cancer

• Hepatocellular Carcinoma

• Pancreatic cancer

• Cholecystitis and choledochitis

• Liver fluke infections