Case 255:   Cholangiocarcinoma

Diagnostic Category:

Clinical Presentation:

57 year old man with abdominal pain.

US: Hypoechoic, in steatosis

Imaging Findings:

Ultrasound prior to biopsy shows the hypoechoic mass within the fatty liver, representing moderately differentiated cholangiocarcinoma.

Typical concentric architecture of carcinoma metastasis: the echogenic tumor center corresponding to desmoplastic stroma reaction is surrounded by a peripheral hypoechoic rim, representing the more cellular and vascular components of the mass (hypervascularity is not reflected in the Color Doppler exam).