No abstract available.
Aged ; *Bile Duct Neoplasms/radiography ; Bile Ducts, Intrahepatic ; *Cholangiocarcinoma/radiography ; Female ; Human ; *Liver Neoplasms/radiography

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

Autoimmune pancreatitis is a distinct disease characterized by the presence of autoantibodies and hypergammaglobulinemia, inflammation of the pancreatic parenchyma, and irregular stricture of the pancreatic duct. The involvement of distal common bile duct is frequently observed, but intrahepatic bile duct involvement is very rare, which seem to have similar feature to primary sclerosing cholangitis. We report a case of the patient with autoimmune pancreatitis combined with extensive involvement of extrahepatic and intrahepatic bile duct, which had a favorable response to steroid therapy.
Aged ; Autoimmune Diseases/complications/*diagnosis/drug therapy ; Bile Ducts, Extrahepatic/*radiography ; Bile Ducts, Intrahepatic/*radiography ; Humans ; Male ; Pancreatitis/complications/*diagnosis/radiography ; Prednisolone/therapeutic use ; Tomography, X-Ray Computed

Owing to the development of multidetector-row CT (MDCT), capability in the imaging diagnosis of liver disease has increased surprisingly. First, a marked decrease in scan duration of the liver enables us to select the accurate scan time optionally. Secondly, a marked decrease in slice thickness enables us to render isotropic and three-dimensional images completely. In this pictorial review, we described the optimal contrast enhancement of the liver on MDCT and its significance as well as the applications of isotropic and three-dimensional images obtained by MDCT.
Bile Duct Neoplasms/diagnosis/*radiography ; Bile Ducts, Intrahepatic/*radiography ; Biliary Tract/radiography ; Cholangiocarcinoma/diagnosis/*radiography ; Cholestasis/*radiography ; Humans ; Imaging, Three-Dimensional ; Tomography, Spiral Computed/instrumentation/*methods

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

A "biloma" is a loculated collection of bile located outside of the biliary tree. It can be caused by traumatic, iatrogenic or spontaneous rupture of the biliary tree. Prior reports have documented an association of biloma with abdominal trauma, surgery and other primary causes, but spontaneous bile leakage has rarely been reported. A spontaneous infected biloma, without any underlying disease, is a very rare finding. We recently diagnosed a spontaneous infected biloma by abdominal computed tomography and sonographically guided percutaneous aspiration. The patient was successfully managed with percutaneous drainage and intravenous antibiotics. We report here a case of infected biloma caused by spontaneous rupture of the intrahepatic duct, and review the relevant medical literature.
Aged ; *Bile ; Bile Duct Diseases/*diagnosis/microbiology/*therapy ; Bile Ducts, Intrahepatic/*radiography ; Cholangiography ; Drainage ; Escherichia coli Infections/*complications ; Female ; Humans ; Rupture, Spontaneous ; Tomography, X-Ray Computed

No abstract available.
Adult ; Bile Ducts, Intrahepatic/pathology ; Caroli Disease/complications/*diagnosis/pathology ; Gallstones/complications/*diagnosis/radiography ; Humans ; Male ; Tomography, X-Ray Computed

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

No abstract available.
Adult ; Bile Duct Neoplasms/*pathology ; Bile Ducts, Intrahepatic/*pathology/radiography ; Caroli Disease/*pathology ; Cholangiocarcinoma/*pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Tomography, X-Ray Computed

We experienced one fatal case of biliary cast syndrome after cadaveric liver transplantation involving both intrahepatic ducts. A 58-year-old man underwent cadaveric liver transplantation because of hepatitis B virus related liver cirrhosis and concomitant hepatocellular carcinoma. Five weeks after the liver transplantation, postoperative course was complicated by development of acute cholangitis. Subsequent endoscopic retrograde cholangiography revealed diffuse intrahepatic bile duct strictures without filling defects. Percutaneous liver biopsy, which was done to exclude rejection, revealed biliary cast. Successful endoscopic removal was precluded due to its diffuse involvement. Because of the deterioration of patient's condition by refractory biliary obstruction and cholangitis, retransplantation from cadaveric donor was performed. Debridement of the biliary tree after graft removal yielded a near-complete cast of the intrahepatic ductal system. Biliary cast syndrome should be suspected when jaundice or cholangitis is associated with dilated ducts on abdominal imaging studies in cadaveric liver transplantation recipients. Initial therapeutic options include removal of biliary cast after endoscopic or percutaneous cholangiography. Although endoscopic retrieval of biliary cast by endoscopic retrograde cholangiopancreatography could be employed as a first-line management, other modalities such as endoscopic nasobiliary drainage, percutaneous transhepatic drainage, or retransplantation should be considered when complete removal is not feasible and the condition of the recipient deteriorates.
Bile Duct Diseases/*diagnosis/etiology/pathology ; Bile Ducts, Extrahepatic/pathology ; Bile Ducts, Intrahepatic/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Fatal Outcome ; Humans ; Jaundice, Obstructive/etiology ; *Liver Transplantation ; Male ; Middle Aged ; Postoperative Complications/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed