Case 25:   Cholangiocarcinoma

Diagnostic Category:

Clinical Presentation:

71 year old woman presents with abdominal pain.

CT: Typical peripheral fibrotic enhancement

Imaging Findings:

Multiphase CT reveals a large central hepatic, biopsy proven cholangiocarcinoma and multiple metastases.  Note typical central necrosis and delayed enhancement of the masses, representing desmoplastic stroma reaction. However more commonly seen with cholangiocarcinoma is the reversed pattern of peripheral washout and fibrotic enhancement centrally.