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Papillary tumor of the bile duct is characterized by the presence of an intraductal tumor with a papillary surface comprising innumerable frondlike infoldings of proliferated columnar epithelial cells surrounding slender fibrovascular stalks. There may be multiple tumors along the bile ducts (papillomatosis or papillary carcinomatosis), which are dilated due to obstruction by a tumor per se, by sloughed tumor debris, or by excessive mucin. Radiologically, the biliary tree is diffusely dilated, either in a lobar or segmental fashion, or aneurysmally, depending on the location of the tumor, the debris, and the amount of mucin production. A tumor can be depicted by imaging as an intraductal mass with a thickened and irregular bile duct wall. Sloughed tumor debris and mucin plugs should be differentiated from bile duct stones. Cystically or aneurysmally, dilated bile ducts in mucin-hypersecreting variants (intraductal papillary mucinous tumors) should be differentiated from cystadenoma, cystadenocarcinoma and liver abscess.
Bile Duct Neoplasms/*radiography ; *Bile Ducts, Extrahepatic ; *Bile Ducts, Intrahepatic ; Carcinoma, Papillary/radiography ; Cystadenoma, Mucinous/radiography ; Diagnosis, Differential ; Female ; Human ; Male ; Middle Age

4.Radiological Staging of Hilar Cholangiocarcinoma.

Jae Ho BYUN

The Korean Journal of Gastroenterology 2005;46(1):7-15

Hilar cholangiocarcinoma is an adenocarcinoma arising from the bile duct epithelium, at the confluence of the right and left intrahepatic bile ducts, within the porta hepatis. In most cases, hilar cholangiocarcinomas are locally invasive tumors which have dismal prognosis if left untreated, with mean survival of approximately three months after the initial presentation. Recently, preoperative assessment of resectability and staging of hilar cholangiocarcinoma has gained importance in better management of the patients. Non-invasive cross-sectional radiological imaging has made considerable advances, and staging of hilar cholangiocarcinomas using radiological examination became more accurate in recent years. In this review, staging of hilar cholangiocarcinoma using computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography, and magnetic resonance angiography is described.
Bile Duct Neoplasms/*diagnosis/radiography ; *Bile Ducts, Intrahepatic/pathology/radiography ; Cholangiocarcinoma/*diagnosis/radiography ; Cholangiopancreatography, Magnetic Resonance ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

5.Cancer Stem Cells in Primary Liver Cancers: Pathological Concepts and Imaging Findings.

Ijin JOO ; Haeryoung KIM ; Jeong Min LEE

Korean Journal of Radiology 2015;16(1):50-68

There is accumulating evidence that cancer stem cells (CSCs) play an integral role in the initiation of hepatocarcinogenesis and the maintaining of tumor growth. Liver CSCs derived from hepatic stem/progenitor cells have the potential to differentiate into either hepatocytes or cholangiocytes. Primary liver cancers originating from CSCs constitute a heterogeneous histopathologic spectrum, including hepatocellular carcinoma, combined hepatocellular-cholangiocarcinoma, and intrahepatic cholangiocarcinoma with various radiologic manifestations. In this article, we reviewed the recent concepts of CSCs in the development of primary liver cancers, focusing on their pathological and radiological findings. Awareness of the pathological concepts and imaging findings of primary liver cancers with features of CSCs is critical for accurate diagnosis, prediction of outcome, and appropriate treatment options for patients.
Bile Duct Neoplasms/pathology/radiography ; Bile Ducts, Intrahepatic/pathology/radiography ; Carcinoma, Hepatocellular/pathology/radiography ; Cholangiocarcinoma/pathology/radiography ; Humans ; Liver Neoplasms/*pathology/radiography ; Magnetic Resonance Imaging ; Neoplastic Stem Cells/*pathology/radiography ; Tomography, X-Ray Computed

6.Benign nodules mimicking hepatocellular carcinoma on gadoxetic acid-enhanced liver MRI.

Kyoung Doo SONG ; Woo Kyoung JEONG

Clinical and Molecular Hepatology 2015;21(2):187-191

7.A Case of Early Bile Duct Cancer Arising from Villous Adenoma in Choledochal Cyst.

Tae Seung LEE ; Hae Kyung KIM ; Hong Min AHN ; Uh Joo LEE ; Young Chul CHOI ; Byung Min JOHN ; Tae Il PARK ; Jin Hoi KOO

The Korean Journal of Gastroenterology 2009;54(1):55-59

Choledochal cyst is an uncommon premalignant anomaly. The morphology and pathogenesis of the premalignant lesion of cholangiocarcinoma arising from the choledochal cyst has not been well described. Herein, we report a rare case of bile duct adenoma arising from choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD). 50-year-old woman was admitted to our hospital with the complaint of epigastric pain. She had received common bile duct (CBD) exploration and choledocholithotomy and cholecystectomy 3 months earlier under the diagnosis of multiple CBD stones. Intraoperalive cholangiogram was not remarkable except CBD dilatation at that time. Endoscopic retrograde cholangiopancreatography revealed choledochal cyst with AUPBD and round filling defect which disappeared easily on the balloon cholaniogram. On magnetic resonance cholangiopancreatography, the filling defect was confirmed as 2 cm polypoid mass attached to the distal bile duct wall. At laparotomy, a soft whitish mass was palpable on the lower CBD. On histological examination, adenoma with focal carcinoma change arising from choledochal cyst was diagnosed.
Adenoma, Villous/*diagnosis/pathology/radiography ; Bile Duct Neoplasms/*diagnosis/pathology/radiography ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/*radiography/secretion/surgery ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed

8.Imaging features and appropriate treatment strategy of a rare biliary tract neoplasm.

Xin-wei YANG ; Jue YANG ; Bao-hua ZHANG ; Feng SHEN ; Kui WANG ; Meng-chao WU

Chinese Medical Journal 2013;126(13):2573-2576

9.Intrahepatic cholangiocarcinoma arising in Caroli's disease.

Min Hye JANG ; Yoon Jin LEE ; Haeryoung KIM

Clinical and Molecular Hepatology 2014;20(4):402-405

10.Choledochoduodenal Fistula after Placement of Endocoil Spiral Stent for Pancreatic Head Cancer.

Sang Hoo PARK ; Soong LEE ; Jae Hong PARK ; Soo In CHOI ; Sang Woo HAN ; Hong Bae PARK

Korean Journal of Gastrointestinal Endoscopy 2000;21(6):951-954

Retrograde endoscopic or percutaneous transhepatic bile duct drainage is the treatment of choice for palliation of malignant biliary obstruction. An expanding metal stent, Endocoil spiral stent, with strong radial force was developed to solve the problems of other metal stents which include obstruction by tumor ingrowth, migration, and epithelial trauma from the distal hard edges of the stent. A choledochoduodenal fistula is occasionally found during endoscopic retrograde cholangiopancreatiography (ERCP) or barium radiography. Cholelithiasis is suspected to be the leading cause in some endemic areas like Korea but duodenal ulcer is more common in Western countries. The case reported here is of a 78-year-old woman, suffering from vomiting, epigastric pain, and abdominal distension, who had a Endocoil spiral stent in the common bile duct (CBD) for pancreatic head cancer for 8 months. During barium radiograph, a fistulous connection between the proximal second part of duodeum and the CBD was identified.
Aged ; Barium ; Bile Ducts ; Cholelithiasis ; Common Bile Duct ; Drainage ; Duodenal Ulcer ; Female ; Fistula* ; Head and Neck Neoplasms* ; Head* ; Humans ; Korea ; Radiography ; Stents* ; Vomiting

1.Peripheral Cholangiocarcinoma.

2.Applications of Multidetector-row CT for the Imaging Diagnosis of Liver Disease.

3.Radiological Spectrum of Intraductal Papillary Tumors of the Bile Ducts.