간내에서 발생한 주변부담관암의 전산화단층촬영 소견 = Computed Tomographic Findings of Intrahepatic Peripheral Cholangiocarcinoma

다국어 초록 (Multilingual Abstract)

Cholangiocarcinoma is synonyumous with bile duct carcinoma, and can originate in a small intrahepatic bile duct(peripheral type), a major intrahepatic duct including the hepatic hilus, an extrahepatic duct, or near the papilla of Vater(central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinima of the liver ; it has the same gross configuration as hepatocellular carcinoma , resulting in difficulty to differentiate on the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinoma of the liver during the last 4 years. The results were as follows : 1. Of 14 cases, 8 were female and 6 were male, and the age ranged form 5th to 7 th decades. 2. Preperative clinical diagnosis were as follows : hepatoma 8 cases, abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7 cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Labratory finding were not specific , but there were only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 cases. intrahepatic duct stones in 1 cases. extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5 cases and CS in 3 cases. 6. Angiographic adn scintigraphic findings were helpful in differential diagnosis from hepatoma but ultrasonogrpaphy was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2 cases. Among solitary cases. the site of involvement of the liver were right lobe in 8 cases and left lobe in 4 cases. 8. Common CT feature of the intrahepatic peripheral cholangiocardinoma of the liver were irregular , inhomogeneous, occasionally peripherally enhancing low density liver mass. frequently accompanied by diffuse or segmental dilatation of the intrahepatic bile duct. If there were normal alphafetoprotein level, positive skin and/or stool examination for CS and difuse or segmental dilatation of the intr hepatic duct in low density liver tumor on the CT, one should consider peripheral cholangiocarcinoma of the liver than heaptoma.