Differentiating cholangiocarcinoma from other diseases

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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:

• Gallbladder cancer
• Hepatocellular Carcinoma
• Pancreatic cancer
• Cholecystitis
• 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