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Intraductal ultrasonography for hepatocellular carcinoma with tumor thrombi in the bile duct: Comparison with polypoid cholangiocarcinoma
Author(s) -
Tamada Kiichi,
Isoda Norio,
Wada Shinichi,
Tomiyama Takeshi,
Ohashi Akira,
Satoh Yukihiro,
Ido Kenichi,
Sugano Kentaro
Publication year - 2001
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2001.02527.x
Subject(s) - medicine , bile duct , hepatocellular carcinoma , radiology , ultrasonography , carcinoma , pathology , gastroenterology
Background and Aim: Tumor thrombi in the bile duct caused by hepatocellular carcinoma (HCC), and cholangiocarcinoma show polypoid lesions on cholangiographic findings. This study prospectively compared the images of intraductal ultrasonography between HCC and polypoid cholangiocarcinoma. Methods: In five patients with tumor thrombi in the bile duct caused by HCC, a 2.0 mm diameter ultrasonic probe with a frequency of 20 MHz was inserted into the bile duct via the transpapillary route ( n = 4) or the transhepatic route ( n = 1). The images were compared to that of 65 patients with cholangiocarcinoma. Results: In all patients with HCC, intraductal ultrasonography showed a ‘polypoid tumor with a narrow base’. In 16 of 65 patients with cholangiocarcinoma, it showed a ‘polypoid tumor with a narrow base’. When intraductal ultrasonography showed a ‘polypoid tumor with a narrow base’, the findings of a positive ‘nodule within a nodule’ (40 vs 0%; P < 0.05), and the absence of a ‘papillary‐surface pattern’ (80 vs 13%; P < 0.05) were more highly associated with tumor thrombi caused by HCC than to polypoid‐type cholangiocarcinoma. Conclusions: Intraductal ultrasonography was useful to distinguish between tumor thrombi caused by HCC and polypoid‐type cholangiocarcinoma.