CCA: Adenocarcinoma arising from bile duct epithelium (cholangiocytes)
Types based on anatomic location
Peripheral (intrahepatic) CCA
Arising from intrahepatic bile ducts distal to 2nd-order branches
Perihilar CCA (Klatskin tumor)
Originates from 1st-order branches of right and left hepatic ducts and bifurcation of both hepatic ducts
Distal CCA
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Mantripragada S et al: Cholangiocarcinoma - part 2, tumoral and nontumoral mimics and imaging features helpful in differentiation. Curr Probl Diagn Radiol. ePub, 2021
Valle JW et al: Biliary tract cancer. Lancet. 397(10272):428-44, 2021
Mamone G et al: The "peripheral wash-out sign" in hepatic malignant lesions. Abdom Radiol (NY). 44(8):2937-8, 2019
Min JH et al: Intrahepatic mass-forming cholangiocarcinoma: arterial enhancement patterns at MRI and prognosis. Radiology. 290(3):691-9, 2019
Rhee H et al: A proposal of imaging classification of intrahepatic mass-forming cholangiocarcinoma into ductal and parenchymal types: clinicopathologic significance. Eur Radiol. 29(6):3111-21, 2019
Lo EC et al: Hepatocellular carcinoma and intrahepatic cholangiocarcinoma: imaging for diagnosis, tumor response to treatment and liver response to Radiation. Semin Radiat Oncol. 28(4):267-6, 2018
Sammon J et al: MRI features of combined hepatocellular- cholangiocarcinoma versus mass forming intrahepatic cholangiocarcinoma. Cancer Imaging. 18(1):8, 2018
Seo N et al: Cross-sectional imaging of intrahepatic cholangiocarcinoma: development, growth, spread, and prognosis. AJR Am J Roentgenol. 209(2):W64-75, 2017
Zhao YJ et al: Differentiation of mass-forming intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma: based on the multivariate analysis of contrast-enhanced computed tomography findings. Abdom Radiol (NY). 41(5):978-89, 2016
Tsunematsu S et al: Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma. Abdom Imaging. 40(6):1492-9, 2015
Apisarnthanarak P et al: The CT appearances for differentiating of peripheral, mass-forming cholangiocarcinoma and liver meatastases from colorectal adenocarcinoma. J Med Assoc Thai. 97(4):415-22, 2014
Roth CG et al: Hepatocellular carcinoma and other hepatic malignancies: MR imaging. Radiol Clin North Am. 52(4):683-707, 2014
Hu XX et al: Retrospective analysis of prognostic factors after liver transplantation for intrahepatic cholangiocarcinoma in China: a single-center experience. Hepatogastroenterology. 58(109):1255-9, 2011
Jiang BG et al: Clinical parameters predicting survival duration after hepatectomy for intrahepatic cholangiocarcinoma. Can J Gastroenterol. 25(11):603-8, 2011
Li YY et al: Clinicopathological characteristics of intrahepatic cholangiocarcinoma in patients with cirrhosis. Hepatogastroenterology. 58(110-111):1787-90, 2011
Yamamoto M et al: Surgical outcomes of intrahepatic cholangiocarcinoma. Surg Today. 41(7):896-902, 2011
Senda Y et al: Value of multidetector row CT in the assessment of longitudinal extension of cholangiocarcinoma: correlation between MDCT and microscopic findings. World J Surg. 33(7):1459-67, 2009
Singal A et al: Role of liver transplantation in the treatment of cholangiocarcinoma. Expert Rev Anticancer Ther. 9(4):491-502, 2009
Menias CO et al: Mimics of cholangiocarcinoma: spectrum of disease. Radiographics. 28(4):1115-29, 2008
Asayama Y et al: Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 238(1):150-5, 2006
Ebied O et al: Hepatocellular-cholangiocarcinoma: helical computed tomography findings in 30 patients. J Comput Assist Tomogr. 27(2):117-24, 2003
Lim JH: Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR Am J Roentgenol. 181(3):819-27, 2003
Maetani Y et al: MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation. AJR Am J Roentgenol. 176(6):1499-507, 2001
Kim TK et al: Peripheral cholangiocarcinoma of the liver: two-phase spiral CT findings. Radiology. 204(2):539-43, 1997
Lacomis JM et al: Cholangiocarcinoma: delayed CT contrast enhancement patterns. Radiology. 203(1):98-104, 1997
Soyer P et al: Imaging of intrahepatic cholangiocarcinoma: 1. Peripheral cholangiocarcinoma. AJR Am J Roentgenol. 165(6):1427-31, 1995
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Cholangiocarcinoma (CCA)
Synonyms
Cholangiocellular carcinoma, intrahepatic CCA
Definitions
CCA: Adenocarcinoma arising from bile duct epithelium (cholangiocytes)
Types based on anatomic location
Peripheral (intrahepatic) CCA
Arising from intrahepatic bile ducts distal to 2nd-order branches
Perihilar CCA (Klatskin tumor)
Originates from 1st-order branches of right and left hepatic ducts and bifurcation of both hepatic ducts
Distal CCA
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Mantripragada S et al: Cholangiocarcinoma - part 2, tumoral and nontumoral mimics and imaging features helpful in differentiation. Curr Probl Diagn Radiol. ePub, 2021
Valle JW et al: Biliary tract cancer. Lancet. 397(10272):428-44, 2021
Mamone G et al: The "peripheral wash-out sign" in hepatic malignant lesions. Abdom Radiol (NY). 44(8):2937-8, 2019
Min JH et al: Intrahepatic mass-forming cholangiocarcinoma: arterial enhancement patterns at MRI and prognosis. Radiology. 290(3):691-9, 2019
Rhee H et al: A proposal of imaging classification of intrahepatic mass-forming cholangiocarcinoma into ductal and parenchymal types: clinicopathologic significance. Eur Radiol. 29(6):3111-21, 2019
Lo EC et al: Hepatocellular carcinoma and intrahepatic cholangiocarcinoma: imaging for diagnosis, tumor response to treatment and liver response to Radiation. Semin Radiat Oncol. 28(4):267-6, 2018
Sammon J et al: MRI features of combined hepatocellular- cholangiocarcinoma versus mass forming intrahepatic cholangiocarcinoma. Cancer Imaging. 18(1):8, 2018
Seo N et al: Cross-sectional imaging of intrahepatic cholangiocarcinoma: development, growth, spread, and prognosis. AJR Am J Roentgenol. 209(2):W64-75, 2017
Zhao YJ et al: Differentiation of mass-forming intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma: based on the multivariate analysis of contrast-enhanced computed tomography findings. Abdom Radiol (NY). 41(5):978-89, 2016
Tsunematsu S et al: Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma. Abdom Imaging. 40(6):1492-9, 2015
Apisarnthanarak P et al: The CT appearances for differentiating of peripheral, mass-forming cholangiocarcinoma and liver meatastases from colorectal adenocarcinoma. J Med Assoc Thai. 97(4):415-22, 2014
Roth CG et al: Hepatocellular carcinoma and other hepatic malignancies: MR imaging. Radiol Clin North Am. 52(4):683-707, 2014
Hu XX et al: Retrospective analysis of prognostic factors after liver transplantation for intrahepatic cholangiocarcinoma in China: a single-center experience. Hepatogastroenterology. 58(109):1255-9, 2011
Jiang BG et al: Clinical parameters predicting survival duration after hepatectomy for intrahepatic cholangiocarcinoma. Can J Gastroenterol. 25(11):603-8, 2011
Li YY et al: Clinicopathological characteristics of intrahepatic cholangiocarcinoma in patients with cirrhosis. Hepatogastroenterology. 58(110-111):1787-90, 2011
Yamamoto M et al: Surgical outcomes of intrahepatic cholangiocarcinoma. Surg Today. 41(7):896-902, 2011
Senda Y et al: Value of multidetector row CT in the assessment of longitudinal extension of cholangiocarcinoma: correlation between MDCT and microscopic findings. World J Surg. 33(7):1459-67, 2009
Singal A et al: Role of liver transplantation in the treatment of cholangiocarcinoma. Expert Rev Anticancer Ther. 9(4):491-502, 2009
Menias CO et al: Mimics of cholangiocarcinoma: spectrum of disease. Radiographics. 28(4):1115-29, 2008
Asayama Y et al: Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 238(1):150-5, 2006
Ebied O et al: Hepatocellular-cholangiocarcinoma: helical computed tomography findings in 30 patients. J Comput Assist Tomogr. 27(2):117-24, 2003
Lim JH: Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR Am J Roentgenol. 181(3):819-27, 2003
Maetani Y et al: MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation. AJR Am J Roentgenol. 176(6):1499-507, 2001
Kim TK et al: Peripheral cholangiocarcinoma of the liver: two-phase spiral CT findings. Radiology. 204(2):539-43, 1997
Lacomis JM et al: Cholangiocarcinoma: delayed CT contrast enhancement patterns. Radiology. 203(1):98-104, 1997
Soyer P et al: Imaging of intrahepatic cholangiocarcinoma: 1. Peripheral cholangiocarcinoma. AJR Am J Roentgenol. 165(6):1427-31, 1995
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