Imaging diagnostic essential of atypical intrahepatic cholangiocellular carcinoma accompanied by abscess

HU Weijuan; ZHANG Xiang

doi:10.19300/j.2016.L4613

Abstract：Objective To investigate the imaging features and diagnostic essential of intrahepatic cholangiocellular carcinoma accompanied by abscess. Methods The clinical data and imaging features of one case of intrahepatic cholangiocellular carcinoma accompanied by abscess were retrospectively analyzed, and literature were reviewed. Results Plain CT scan showed a huge mass which involved the left lobe and right anterior lobe of the liver with the lobulated, ill-defined boundary, inhomogenous internal density, and no vascular invasion and adjacent hepatic capsular retraction were found. Contrast enhanced CT examination of arterial phase showed a multi-nodule fusion mass, which has the evident enhanced edge of the lesion and the internal multiple nodules. The mass enhancement was still obvious on portal vein phase and equilibrium phase. Liver MRI scan showed an irregular shaped mass with slightly low signal on T 1-weighted and slightly high signal on T2-weighted images;the mass were inhomogeneous high signal intensity on the DWI. Imaging appearances of contrast enhanced MR scanning were similar to enhanced CT. A local area with loculated enhanced more significantly than the edge of the mass were found within the mass on portal vein and equilibrium phase. Conclusion The imaging features of atypical cholangiocellular carcinoma accompanied by hepatic abscess include the characteristic signs of both diseases. To obtain a correct imaging diagnosis, clinical data, laboratory examination and ultrasonography findings should be concerned and most importantly, detailed CT and MR findings should be emphasized and analyzed.