Radiology Lectures | Radquarters

Case of the Week: Perihilar Cholangiocarcinoma/Klatskin Tumor (CT & MRI)

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In this radiology lecture, we discuss the CT and MRI appearance of perihilar cholangiocarcinoma.

Key points include:

  • Perihilar cholangiocarcinoma (AKA Klatskin tumor) occurs at bifurcation of the hepatic duct.
  • Cholangiocarcinoma (CC) is a primary malignant tumor of bile duct epithelium, usually adenocarcinoma.
  • CC is the most common primary hepatic malignancy after hepatocellular carcinoma (HCC), and most are extrahepatic (as opposed to intrahepatic).
  • Appearance of CC is based on growth pattern: Mass-forming, periductal infiltrating, and intraductal growing.
  • Risk factors: Parasite infection, choledochal cyst, primary sclerosing cholangitis, recurrent pyogenic cholangitis, and inflammatory bowel disease (ulcerative colitis).
  • Patients are usually 65 or older.
  • On CT and MRI, perihilar CC appears as a biliary stricture with shouldering/abrupt tapering.
  • If a mass is visible, will typically have rimlike enhancement with gradual centripetal enhancement on delayed images, be T2 bright (but not as homogeneous or as bright as hemangioma), and may have a targetlike appearance on DWI (favors CC over HCC).

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    The post Case of the Week: Perihilar Cholangiocarcinoma/Klatskin Tumor (CT & MRI) appeared first on Radquarters.

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    Radiology Lectures | RadquartersBy Daniel J. Kowal, MD
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