74 year old Korean woman with elevated serum bilirubin level.
CT shows numerous small confluent adenomas (papillomatosis) predominantly in the left intrahepatic duct, but also in the common bile duct. Note distention of biliary system due to mucin production of biliary tumors. Histology showed cholangiocarcinoma with underlying intrabiliary mucin producing neoplasia (IMPN).
Courtesy Jae Ho Byun MD, PhD, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.