[Comparison study of small peripheral intrahepatic cholangiocarcinoma with computed tomographic and pathological...

To explore the computed tomographic (CT) and pathological findings of small intrahepatic cholangiocarcinoma and improve its understanding.

A total of 20 patients with bile duct non-dilatation peripheral small intrahepatic cholangiocarcinoma were retrospectively analyzed. All of them were examined by plain and enhanced CT and pathological studies.

CT plain scan:there were 15 cases of low-density lesions with fibers and necrotic tissue and surviving tumor tissue in peripheral or central portions. There were 4 cases of lesions with mixed high and low densities. Abundant necrotic tissues were found with a rare vascular distribution.Or abundant fibers and connective tissues around tumor were manifested as hardened cholangiocarcinoma.One lesion showed equal density with abundant necrotic tissue and fibrous connective tissue with peripheral tumor tissue; dynamic contrast-enhanced CT: (1) there were 6 cases of lesion with peripheral thin ring-enhanced and tumor margin of viable tumor tissue. And internal tumor was fibrous tissue; (2) there were 7 cases of lesions with peripheral thick ring-enhanced and enhanced portion was surviving tumor tissue, no enhanced central portion was mainly necrotic tissue mixed with little fibrous tissue; (3) there were 2 cases of whole tumors without enhancement. There were significant hemorrhage and necrosis with few surviving tumor cells in tumor and normal liver tissue; (4) there were 5 cases of lesions with heterogeneous enhancement and the heterogeneous enhancement portion was surviving tumor tissue and little fibrous connective tissue. And some necrotic tissue remained; (5) only one case had overall enhancement of same-sized tumor cells without necrosis.

CT scanning of peripheral small cholangiocarcinoma lacks distinguishing characteristics. However the findings of contrast-enhanced CT have certain characteristics. Due to different pathological types, each attribute has corresponding characteristic with different pathological features.