CT Characteristics and Misdiagnosis Analysis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma_West China Medical Journal

Authors：

 LANYu-mei ¹ ,  LIULi ²

1. Department of Radiology, Renshou People's Hospital, Renshou, Sichuan 620500, P. R. China;
2. Department of Radiology, Chongqing Yubei People's Hospital, Chongqing 401120, P. R. China;

Corresponding author：

LIULi, Email: drliuli@163.com

Keywords：

Combined hepatocellular carcinoma; Tomography, X-ray computed; Misdiagnosis

DOI：

10.7507/1002-0179.20150478

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the CT characteristics of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC), and analyze the reasons for its misdiagnosis. Method We retrospectively analyzed the CT data of 7 patients diagnosed to have combined hepatocellular carcinoma and cholangiocarcinoma by postoperative pathological analysis between January 2009 and February 2015. We analyzed such characteristics as location, shape, density, enhanced features, surrounding invasion, mediastinal lymph node metastasis, cirrhosis and pyoperitoneum of the disease. Results There were 7 tumors among the 7 patients. Plain scan showed slightly lower density nodules or masses. After the enhancement of arterial phase, 5 tumors showed obvious inhomogeneous enhancement but 2 mild marginal enhancement. During the portal venous phase and the delay stage, the regional degree of tumor foci was significantly decreased, but some regions sustained annular or nodular and patchy enhancement. Among the 7 cases, the portal vein was invaded in 2, bile duct in 1, lymph node metastasis in 2, cirrhosis in 1, and peritoneal effusion in 1. Preoperative diagnosis was correct in only 2 cases and the other 5 cases were misdiagnosed by CT. Conclusions The cHCC-CC possesses some characteristic appearances on CT. Analyzing the characteristics carefully combining with symptom and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.

Citation： LANYu-mei, LIULi. CT Characteristics and Misdiagnosis Analysis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma. West China Medical Journal, 2015, 30(9): 1679-1682. doi: 10.7507/1002-0179.20150478 Copy

1.	言伟强, 王成林, 刘远健, 等. 肝血管瘤的螺旋CT三期扫描分析[J]. 中国CT和MRI杂志, 2004, 2(3):34-37.
2.	李桂梅, 杨志慧, 潘书梅. 混合型原发性肝癌12例临床病理分析[J]. 诊断病理学杂志, 2013, 20(8):458-465.
3.	李文见. 混合型肝癌临床及影像学诊断分析[J]. 河南医学研究, 2014, 23(2):93-95.
4.	张旭光, 王杰, 李权, 等. 混合型肝癌组织中OV6与Snail蛋白的表达及临床意义[J]. 实用临床医药杂志, 2014, 18(11):17-20.
5.	Kassahun WT, Hauss J. Management of combined hepatocellular and cholangiocarcinoma[J]. Int J Clin Pract, 2008, 62(8):1271-1278.
6.	Yin X, Zhang BH, Qiu SJ, et al. Combined hepatocellular carcinoma and cholangiocarcinoma:clinical features, treatment modalities, and prognosis[J]. Ann Surg Oncol, 2012, 19(9):2869-2876.
7.	李英丽, 吴秀蓉. 混合型肝癌的CT和MRI表现[J]. 中华放射学杂志, 2012, 46(8):701-704.
8.	Allen RA, Lisa JR. Combined liver cell and bile duct carcinoma[J]. Am J Pathol, 1949, 25(4):647-655.
9.	文亮, 韩丹. 混合型肝癌3例CT表现并文献复习[J]. 临床放射学杂志, 2012, 31(10):1512-1515.
10.	赵峰, 许顺良, 林坚, 等. 26例混合细胞性肝癌的CT和MRI诊断[J]. 中国临床医学影像杂志, 2010, 21(11):804-806.
11.	陆伦, 邵丹丹, 龙行安, 等. 混合型肝癌的CT、MRI表现及临床病理分析[J]. 实用放射学杂志, 2013, 29(4):579-582.
12.	Uenishi T, Hirohashi K, Shuto T, et al. Surgery for mixed hepatocellular and cholangiocellular carcinoma[J]. Hepatogastroenterology, 2000, 47(33):832-834.
13.	Toh CH, Cheung YC, Ng SH, et al. Combined hepatocellular-cholangiocarcinoma:a case report[J]. Int J Clin Pract, 2004, 58(12):1170-1173.
14.	Sanada Y, Shiozaki S, Aoki H, et al. A clinical study of 11 cases of combined hepatocellular-cholangiocarcinoma assessment of enhancement patterns on dynamics computed tomography before resection[J]. Hepatol Res, 2005, 32(3):185-195.
15.	Ebied O, Federle MP, Blachar A, et al. Hepatocellular-cholangiocarcinoma:helical computed tomography findings in 30 patients[J]. J Comput Assist Tomoqr, 2003, 27(2):117-124.
16.	徐立斌, 赵东兵, 邵水孚, 等. 混合细胞性肝癌14例的诊断及外科治疗效果分析[J]. 中华普通外科杂志, 2003, 18(2):90-92.
17.	Asayama Y, Taguchi Ki K, Aishima Si S, et al. The mode of tumor progression in combined hepatocellular carcinoma and cholangiocarcinoma:an immunohistochemical analysis of ecadherin, alpha-cartenin and beta-cartenin[J]. Liver, 2002, 22(1):43-50.
18.	岳建兰, 季倩, 沈文. 混合型肝癌临床及影像学分析[J]. 实用放射学杂志, 2013, 29(1):52-55, 76.

1. 言伟强, 王成林, 刘远健, 等. 肝血管瘤的螺旋CT三期扫描分析[J]. 中国CT和MRI杂志, 2004, 2(3):34-37.
2. 李桂梅, 杨志慧, 潘书梅. 混合型原发性肝癌12例临床病理分析[J]. 诊断病理学杂志, 2013, 20(8):458-465.
3. 李文见. 混合型肝癌临床及影像学诊断分析[J]. 河南医学研究, 2014, 23(2):93-95.
4. 张旭光, 王杰, 李权, 等. 混合型肝癌组织中OV6与Snail蛋白的表达及临床意义[J]. 实用临床医药杂志, 2014, 18(11):17-20.
5. Kassahun WT, Hauss J. Management of combined hepatocellular and cholangiocarcinoma[J]. Int J Clin Pract, 2008, 62(8):1271-1278.
6. Yin X, Zhang BH, Qiu SJ, et al. Combined hepatocellular carcinoma and cholangiocarcinoma:clinical features, treatment modalities, and prognosis[J]. Ann Surg Oncol, 2012, 19(9):2869-2876.
7. 李英丽, 吴秀蓉. 混合型肝癌的CT和MRI表现[J]. 中华放射学杂志, 2012, 46(8):701-704.
8. Allen RA, Lisa JR. Combined liver cell and bile duct carcinoma[J]. Am J Pathol, 1949, 25(4):647-655.
9. 文亮, 韩丹. 混合型肝癌3例CT表现并文献复习[J]. 临床放射学杂志, 2012, 31(10):1512-1515.
10. 赵峰, 许顺良, 林坚, 等. 26例混合细胞性肝癌的CT和MRI诊断[J]. 中国临床医学影像杂志, 2010, 21(11):804-806.
11. 陆伦, 邵丹丹, 龙行安, 等. 混合型肝癌的CT、MRI表现及临床病理分析[J]. 实用放射学杂志, 2013, 29(4):579-582.
12. Uenishi T, Hirohashi K, Shuto T, et al. Surgery for mixed hepatocellular and cholangiocellular carcinoma[J]. Hepatogastroenterology, 2000, 47(33):832-834.
13. Toh CH, Cheung YC, Ng SH, et al. Combined hepatocellular-cholangiocarcinoma:a case report[J]. Int J Clin Pract, 2004, 58(12):1170-1173.
14. Sanada Y, Shiozaki S, Aoki H, et al. A clinical study of 11 cases of combined hepatocellular-cholangiocarcinoma assessment of enhancement patterns on dynamics computed tomography before resection[J]. Hepatol Res, 2005, 32(3):185-195.
15. Ebied O, Federle MP, Blachar A, et al. Hepatocellular-cholangiocarcinoma:helical computed tomography findings in 30 patients[J]. J Comput Assist Tomoqr, 2003, 27(2):117-124.
16. 徐立斌, 赵东兵, 邵水孚, 等. 混合细胞性肝癌14例的诊断及外科治疗效果分析[J]. 中华普通外科杂志, 2003, 18(2):90-92.
17. Asayama Y, Taguchi Ki K, Aishima Si S, et al. The mode of tumor progression in combined hepatocellular carcinoma and cholangiocarcinoma:an immunohistochemical analysis of ecadherin, alpha-cartenin and beta-cartenin[J]. Liver, 2002, 22(1):43-50.
18. 岳建兰, 季倩, 沈文. 混合型肝癌临床及影像学分析[J]. 实用放射学杂志, 2013, 29(1):52-55, 76.

West China Medical Journal

CT Characteristics and Misdiagnosis Analysis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content