Case 23:   Cholangiocarcinoma

Diagnostic Category:

Clinical Presentation:

49 year old man presents with jaundice.

CT: Mass-like, central with portal vein invasion

Imaging Findings:

Multiphase CT reveals a large central, biopsy proven cholangiocarcinoma. The mass is peripherally vascular with central necrosis. Enhancement in the 10 minute equilibrium phase suggests desmoplastic stroma. Bilobar intrahepatic biliary ductal dilation and left portal vein invasion (arrowheads) are seen. Note the reactive hypervascularity in liver segments 4A and 8, likely due to the left portal vein invasion. Cavernous transformation of the proximal main portal vein (long arrow) is due to high grade encasement (short arrow) of the portal vein by the mass.