Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
World J Gastroenterol. 2012 Mar 21;18(11):1273-8. doi: 10.3748/wjg.v18.i11.1273.
Non-hepatocellular carcinoma (non-HCC) with macroscopic bile duct tumor thrombus (BDTT) formation is rare, few radiological studies have been reported. In this case report, we retrospectively analyzed the imaging findings of three cases of non-HCC with macroscopic BDTT on dynamic enhanced multislice computed tomography (MSCT) scan. One case of primary hepatic carcinosarcoma was presented as a solitary, large well-defined tumor with significant necrotic changes. One case of liver metastasis from colon cancer was presented as a lobulated, large ill-defined tumor. One case of intraductal oncocytic papillary neoplasm involved the entire pancreas, presented as a cystic and solid mass with multilocular changes (the individual loculi were less than 5.0 mm in diameter). The bile duct was dilated due to expansible growth of the BDTT in all three patients. The BDTT was contiguous with hepatic or pancreatic tumor, and both of them showed the same enhancement patterns on dynamic contrast-enhanced computed tomography scan: early enhancement in the hepatic arterial phase and a quick wash-out of contrast agent in the portal and equilibrium phases. Macroscopic BDTT in non-HCC patient is rare, dynamic enhanced MSCT scan may be valuable in the diagnosis of non-HCC with BDTT.
非肝细胞癌（非 HCC）伴宏观胆管癌栓（BDTT）形成较为罕见，相关影像学研究较少。本病例报告回顾性分析了 3 例非 HCC 伴宏观 BDTT 的动态增强多层螺旋 CT（MSCT）扫描的影像学表现。1 例原发性肝肉瘤癌表现为单发、大而界限清楚的肿瘤，伴显著坏死改变。1 例结肠癌肝转移表现为分叶状、大而界限不清的肿瘤。1 例肝内胆管嗜酸细胞乳头状肿瘤累及整个胰腺，表现为囊实性肿块，多房改变（各个房腔直径均小于 5.0mm）。由于 BDTT 的膨胀性生长，所有 3 例患者的胆管均扩张。BDTT 与肝或胰腺肿瘤相连，两者在动态对比增强 CT 扫描上均显示出相同的增强模式：肝动脉期早期强化，门静脉和平衡期迅速洗脱造影剂。非 HCC 患者的宏观 BDTT 较为罕见，动态增强 MSCT 扫描有助于诊断伴 BDTT 的非 HCC。
