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Histological confirmation of periductal fibrosis from ultrasound diagnosis in cholangiocarcinoma patients
Author(s) -
Chamadol Nittaya,
Pairojkul Chawalit,
Khuntikeo Narong,
Laopaiboon Vallop,
Loilome Watcharin,
Sithithaworn Paiboon,
Yongvanit Paungrat
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.64
Subject(s) - medicine , fibrosis , magnetic resonance imaging , radiology , intrahepatic cholangiocarcinoma , pathology , opisthorchis viverrini , hepatocellular carcinoma , stage (stratigraphy) , bile duct , liver fluke , biology , paleontology , immunology , helminths
Cholangiocarcinoma ( CCA ) has no specific clinical signs and symptoms and non‐specific bio‐ and tumor‐markers in the early disease stage. Usually patients present to tertiary care with advanced disease stage. In order to detect early cases of CCA that may present as a mass, dilatation of intrahepatic duct or combination, ultrasonography is accepted as a powerful imaging tool. A smaller mass or bile duct segmental dilatation requires further imaging for characterization, including computerized tomography ( CT ) or magnetic resonance imaging ( MRI ). We examined whether liver echo pattern was correlated with high risk for CCA in an endemic area of O pisthorchis viverrini ( O v). O v infestation caused chronic inflammation of the biliary tree by periductal fibrosis ( PDF ), which may subsequently lead to CCA development. In our study, a World Health Organization classification of pattern of increased periportal echo ( IPE ) for schistosomiasis was applied. Two CCA patients gave consent for operation. Histopathological diagnosis showed both had cholangiocarcinoma with periductal fibrosis of the non‐tumorous area of the liver. Ultrasonography was used to compare the non‐tumorous area with parenchymal echo pattern and was shown to have an early CCA detection role and a surveillance role in an endemic area of O v by detection of PDF .