| Diagnosis of bile duct hepatocellular carcinoma thrombus without obvious intrahepatic mass. | |
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MedLine Citation:
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PMID: 20954289 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To study the diagnosis of hepatocellular carcinoma (HCC) presenting as bile duct tumor thrombus with no detectable intrahepatic mass. METHODS: Six patients with pathologically proven bile duct HCC thrombi but no intrahepatic mass demonstrated on the preoperative imaging or palpated intrahepatic mass during operative exploration, were collected. Their clinical and imaging data were retrospectively analyzed. The major findings or signs on comprehensive imaging were correlated with the surgical and pathologic findings. RESULTS: Jaundice was the major clinical symptom of the patients. The elevated serum total bilirubin, direct bilirubin and alanine aminotransferase levels were in concordance with obstructive jaundice and the underlying liver disease. Of the 6 patients showing evidence of viral hepatitis, 5 were positive for serum alpha fetoprotein and carbohydrate antigen 19-9, and 1 was positive for serum carcinoembryonic antigen. No patient was correctly diagnosed by ultrasound. The main features of patients on comprehensive imaging were filling defects with cup-shaped ends of the bile duct, with large filling defects presenting as casting moulds in the expanded bile duct, hypervascular intraluminal nodules, debris or blood clots in the bile duct. No obvious circular thickening of the bile duct walls was observed. CONCLUSION: Even with no detectable intrahepatic tumor, bile duct HCC thrombus should be considered in patients predisposed to HCC, and some imaging signs are indicative of its diagnosis. |
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Authors:
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Xue-Ying Long; Yi-Xiong Li; Wei Wu; Lang Li; Jue Cao |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 16 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2011-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 4998-5004 Citation Subset: IM |
Affiliation:
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Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alanine Transaminase
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blood Bile Ducts / pathology*, ultrasonography Bilirubin / blood CA-19-9 Antigen / blood Carcinoembryonic Antigen / blood Carcinoma, Hepatocellular / blood, complications, diagnosis*, pathology Cholangiopancreatography, Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Cholestasis / blood, etiology*, pathology Female Humans Jaundice, Obstructive / blood, etiology*, pathology Liver Neoplasms / blood, complications, diagnosis*, pathology Male Middle Aged Neoplasm Invasiveness Retrospective Studies Tomography, X-Ray Computed alpha-Fetoproteins / analysis |
| Chemical | |
Reg. No./Substance:
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0/AFP protein, human; 0/CA-19-9 Antigen; 0/Carcinoembryonic Antigen; 0/alpha-Fetoproteins; 635-65-4/Bilirubin; EC 2.6.1.2/Alanine Transaminase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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