Lim JH (2003) Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR Am J Roentgenol, 181(3):819-827
IntroductionThe prognosis for mass-forming and periductal-infiltrating cholangiocarcinomas is generally unfavorable, whereas the prognosis for intraductal-growing cholangiocarcinoma is much better (or excellent) after surgical resection [11–14].
Intrahepatic Cholangiocarcinoma
In short, mass-forming intrahepatic cholangiocarcinoma shows a large, well-defined, irregular mass with frequent satellite nodules, periductal-infiltrating cholangiocarcinoma results in obliteration of the bile ducts and proximal dilatation without an identifiable mass, and intraductal-growing cholangiocarcinoma presents with focal or segmental bile duct dilatation with or without visible intraductal papillary tumors.
Extrahepatic Cholangiocarcinoma
In short, mass-forming extrahepatic cholangiocarcinoma results in bile duct obstruction by a small mass; periductal-infiltrating cholangiocarcinoma produces segmental or diffuse, concentric thickening of the wall of the bile ducts without a focal mass; and intraductal- growing cholangiocarcinoma produces bile duct dilatation with single or multiple papillary intraductal masses.
Mode of Spread
Mass forming Cholangiocarcinoma: Intrahepatic cholangiocarcinoma arises from the mucosa of a branch of the bile ducts in the peripheral or hilar area of the liver, invades and penetrates the bile duct wall, spreads between hepatocyte plates, expands via the hepatic sinusoidal spaces [1], and grows three dimensionally. Similar to hepatocellular carcinomas, tumor cells have a propensity to invade small portal venous branches adjacent to the primary mass as a portal venous tumor thrombus [1, 5, 6, 11, 21]. As the primary mass and adjacent satellite tumors within the portal vein grow, they fuse together and form a large mass (Fig. 12). therefore, the tumor margin is usually irregular, rolled, or lobulated.
Periductal-Infiltrating Choangicarcinoma: In contrast to mass-forming cholangiocarcinoma, periductal-infiltrating cholangiocarcinoma tends to spread along the bile duct wall via the nerve and perineural tissue of Glisson’s capsule toward the porta hepatis [1, 6]. Thus, the tumor grows longitudinally and extends along the axis of the bile duct like a branch of a tree [4].
IntroductionThe prognosis for mass-forming and periductal-infiltrating cholangiocarcinomas is generally unfavorable, whereas the prognosis for intraductal-growing cholangiocarcinoma is much better (or excellent) after surgical resection [11–14].
Intrahepatic Cholangiocarcinoma
In short, mass-forming intrahepatic cholangiocarcinoma shows a large, well-defined, irregular mass with frequent satellite nodules, periductal-infiltrating cholangiocarcinoma results in obliteration of the bile ducts and proximal dilatation without an identifiable mass, and intraductal-growing cholangiocarcinoma presents with focal or segmental bile duct dilatation with or without visible intraductal papillary tumors.
Extrahepatic Cholangiocarcinoma
In short, mass-forming extrahepatic cholangiocarcinoma results in bile duct obstruction by a small mass; periductal-infiltrating cholangiocarcinoma produces segmental or diffuse, concentric thickening of the wall of the bile ducts without a focal mass; and intraductal- growing cholangiocarcinoma produces bile duct dilatation with single or multiple papillary intraductal masses.
Mode of Spread
Mass forming Cholangiocarcinoma: Intrahepatic cholangiocarcinoma arises from the mucosa of a branch of the bile ducts in the peripheral or hilar area of the liver, invades and penetrates the bile duct wall, spreads between hepatocyte plates, expands via the hepatic sinusoidal spaces [1], and grows three dimensionally. Similar to hepatocellular carcinomas, tumor cells have a propensity to invade small portal venous branches adjacent to the primary mass as a portal venous tumor thrombus [1, 5, 6, 11, 21]. As the primary mass and adjacent satellite tumors within the portal vein grow, they fuse together and form a large mass (Fig. 12). therefore, the tumor margin is usually irregular, rolled, or lobulated.
Periductal-Infiltrating Choangicarcinoma: In contrast to mass-forming cholangiocarcinoma, periductal-infiltrating cholangiocarcinoma tends to spread along the bile duct wall via the nerve and perineural tissue of Glisson’s capsule toward the porta hepatis [1, 6]. Thus, the tumor grows longitudinally and extends along the axis of the bile duct like a branch of a tree [4].
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