Ultrasound images of Cholangiocarcinoma

This is a malignant lesion arising in the wall of the bile duct. It is obviously easier to recognize from an ultrasound point of view when it occurs in and obstructs the common duct, as the subsequent dilatation outlines the proximal part of the tumour with bile. Cholangiocarcinoma may occur at any level along the biliary tree and is frequently multifocal.

A cholangiocarcinoma is referred to as a Klatskin tumour when it involves the confluence of the right and left hepatic ducts. These lesions are often difficult to detect on both ultrasound and CT. They are frequently isoechoic, and the only clue may be the proximal dilatation of the biliary ducts (Fig. H).
Although rare, the incidence of cholangiocarcinoma seems to be increasing and it is strongly associated with PSC, a disease of the biliary ducts which predominantly affects young men (see above).
Multifocal cholangiocarcinoma may spread to the surrounding liver tissue and carries a very poor prognosis for long-term survival. In a liver whose texture is already altered by diffuse disease it may be almost impossible to identify these lesions before they become large. A pattern of dilated ducts distal to the lesion is a good clue. FIGS B & C

Cholangiocarcinoma. (A) Irregular mass at the porta, causing biliary obstruction—a Klatskin tumour.
(B) MRI of the same patient, confirming the mass at the porta.

FIG B

Focally dilated ducts distal to a
hyperechoic cholangiocarcinoma (calipers)

FIG C

Cholangiocarcinoma invading the CBD
(arrow).

ULTRASOUND IMAGES Cholangiocarcinoma , ultrasound images hyperechoic cholangiocarcinoma, ultrasound images of Cholangiocarcinoma.

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