Case 349:   Cholangiocarcinoma

Diagnostic Category:

Clinical Presentation:

58 year old woman with Hepatitis C.

CT: Calcifications and fibrotic enhancement

Imaging Findings:

Multiphase CT of the liver shows a well-defined enhancing mass in segment 2/3 in a cirrhotic liver.  This lesion is calcified, shows peripheral enhancement in the arterial phase with progressive centripetal enhancement in the portal venous and equilibrium images.  Equilibrium phase shows enhancement denser than blood pool, distinguishing the lesion from cavernous hemangioma.  Biopsy confirmed cholangiocarcinoma. Up to 10% of cholangiocarcinomas are calcified.

Note signs of cirrhosis: nodular liver with prominent left lobe.