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Cholangiocarcinoma and Gallbladder Cancer
Fathima Fijula P. Manzil, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Scanning Tips

        TERMINOLOGY

        • Abbreviations

          • Cholangiocarcinoma (CC): Primary carcinoma originating at any bile duct segment from terminal ductules to ampulla
            • Intrahepatic (iCC), perihilar (pCC), extrahepatic (eCC)
        • Definitions

          • CC: Primary carcinoma originating at any bile duct segment from terminal ductules to ampulla
            • > 90% are adenocarcinomas
            • Morphologic types: Mass-forming (most common), periductal-infiltrating (poor prognosis), intraductal growth
            • Histologic types: Nodular, sclerosing (common type), papillary (rare form, favorable prognosis among CC)
            • iCC: ~ 10% of CC
              • Originate from bile ducts within liver
              • Combined hepatocellular-cholangiocarcinoma (primary liver carcinoma with biphenotypic differentiation) is staged as iCC
            • pCC: 50-70% of CC
              • CC at site where bile ducts exit liver
              • Klatskin tumor: CC where right and left hepatic ducts meet, forming common hepatic duct
            • eCC: 20-40% of CC
              • CC in bile ducts outside liver
          • Gallbladder carcinoma (GBC)
            • 98% are of epithelial origin, ~ 90% are adenocarcinoma
            • 60% from fundus, 30% from body, 10% from neck

        IMAGING

        • Imaging Recommendations

          DIFFERENTIAL DIAGNOSIS

            PATHOLOGY

            • General Features

              • Staging, Grading, & Classification

                CLINICAL ISSUES

                • Presentation

                  • Natural History & Prognosis

                    • Treatment

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        Selected References

                        1. Cheng Z et al: Coming of a precision era of the staging systems for intrahepatic cholangiocarcinoma? Cancer Lett. 460:10-7, 2019
                        2. Huguet JM et al: Diagnostic-therapeutic management of bile duct cancer. World J Clin Cases. 7(14):1732-52, 2019
                        3. Krampitz GW et al: Staging of biliary and primary liver tumors: current recommendations and workup. Surg Oncol Clin N Am. 28(4):663-83, 2019
                        4. Hennedige TP et al: Imaging of malignancies of the biliary tract- an update. Cancer Imaging. 14(1):14, 2014
                        5. Lan BY et al: Positron emission tomography in hepatobiliary and pancreatic malignancies: a review. Am J Surg. 204(2):232-41, 2012
                        6. www.nccn.org; Guideline for treatment of hepatobiliary malignancies
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Scanning Tips

                              TERMINOLOGY

                              • Abbreviations

                                • Cholangiocarcinoma (CC): Primary carcinoma originating at any bile duct segment from terminal ductules to ampulla
                                  • Intrahepatic (iCC), perihilar (pCC), extrahepatic (eCC)
                              • Definitions

                                • CC: Primary carcinoma originating at any bile duct segment from terminal ductules to ampulla
                                  • > 90% are adenocarcinomas
                                  • Morphologic types: Mass-forming (most common), periductal-infiltrating (poor prognosis), intraductal growth
                                  • Histologic types: Nodular, sclerosing (common type), papillary (rare form, favorable prognosis among CC)
                                  • iCC: ~ 10% of CC
                                    • Originate from bile ducts within liver
                                    • Combined hepatocellular-cholangiocarcinoma (primary liver carcinoma with biphenotypic differentiation) is staged as iCC
                                  • pCC: 50-70% of CC
                                    • CC at site where bile ducts exit liver
                                    • Klatskin tumor: CC where right and left hepatic ducts meet, forming common hepatic duct
                                  • eCC: 20-40% of CC
                                    • CC in bile ducts outside liver
                                • Gallbladder carcinoma (GBC)
                                  • 98% are of epithelial origin, ~ 90% are adenocarcinoma
                                  • 60% from fundus, 30% from body, 10% from neck

                              IMAGING

                              • Imaging Recommendations

                                DIFFERENTIAL DIAGNOSIS

                                  PATHOLOGY

                                  • General Features

                                    • Staging, Grading, & Classification

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Cheng Z et al: Coming of a precision era of the staging systems for intrahepatic cholangiocarcinoma? Cancer Lett. 460:10-7, 2019
                                              2. Huguet JM et al: Diagnostic-therapeutic management of bile duct cancer. World J Clin Cases. 7(14):1732-52, 2019
                                              3. Krampitz GW et al: Staging of biliary and primary liver tumors: current recommendations and workup. Surg Oncol Clin N Am. 28(4):663-83, 2019
                                              4. Hennedige TP et al: Imaging of malignancies of the biliary tract- an update. Cancer Imaging. 14(1):14, 2014
                                              5. Lan BY et al: Positron emission tomography in hepatobiliary and pancreatic malignancies: a review. Am J Surg. 204(2):232-41, 2012
                                              6. www.nccn.org; Guideline for treatment of hepatobiliary malignancies