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：

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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.	言偉強, 王成林, 劉遠健, 等. 肝血管瘤的螺旋CT三期掃描分析[J]. 中國CT和MRI雜志, 2004, 2(3):34-37.
2.	李桂梅, 楊志慧, 潘書梅. 混合型原發性肝癌12例臨床病理分析[J]. 診斷病理學雜志, 2013, 20(8):458-465.
3.	李文見. 混合型肝癌臨床及影像學診斷分析[J]. 河南醫學研究, 2014, 23(2):93-95.
4.	張旭光, 王杰, 李權, 等. 混合型肝癌組織中OV6與Snail蛋白的表達及臨床意義[J]. 實用臨床醫藥雜志, 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.	李英麗, 吳秀蓉. 混合型肝癌的CT和MRI表現[J]. 中華放射學雜志, 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, 韓丹. 混合型肝癌3例CT表現并文獻復習[J]. 臨床放射學雜志, 2012, 31(10):1512-1515.
10.	趙峰, 許順良, 林堅, 等. 26例混合細胞性肝癌的CT和MRI診斷[J]. 中國臨床醫學影像雜志, 2010, 21(11):804-806.
11.	陸倫, 邵丹丹, 龍行安, 等. 混合型肝癌的CT、MRI表現及臨床病理分析[J]. 實用放射學雜志, 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, 趙東兵, 邵水孚, 等. 混合細胞性肝癌14例的診斷及外科治療效果分析[J]. 中華普通外科雜志, 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.	岳建蘭, 季倩, 沈文. 混合型肝癌臨床及影像學分析[J]. 實用放射學雜志, 2013, 29(1):52-55, 76.

1. 言偉強, 王成林, 劉遠健, 等. 肝血管瘤的螺旋CT三期掃描分析[J]. 中國CT和MRI雜志, 2004, 2(3):34-37.
2. 李桂梅, 楊志慧, 潘書梅. 混合型原發性肝癌12例臨床病理分析[J]. 診斷病理學雜志, 2013, 20(8):458-465.
3. 李文見. 混合型肝癌臨床及影像學診斷分析[J]. 河南醫學研究, 2014, 23(2):93-95.
4. 張旭光, 王杰, 李權, 等. 混合型肝癌組織中OV6與Snail蛋白的表達及臨床意義[J]. 實用臨床醫藥雜志, 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. 李英麗, 吳秀蓉. 混合型肝癌的CT和MRI表現[J]. 中華放射學雜志, 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, 韓丹. 混合型肝癌3例CT表現并文獻復習[J]. 臨床放射學雜志, 2012, 31(10):1512-1515.
10. 趙峰, 許順良, 林堅, 等. 26例混合細胞性肝癌的CT和MRI診斷[J]. 中國臨床醫學影像雜志, 2010, 21(11):804-806.
11. 陸倫, 邵丹丹, 龍行安, 等. 混合型肝癌的CT、MRI表現及臨床病理分析[J]. 實用放射學雜志, 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, 趙東兵, 邵水孚, 等. 混合細胞性肝癌14例的診斷及外科治療效果分析[J]. 中華普通外科雜志, 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. 岳建蘭, 季倩, 沈文. 混合型肝癌臨床及影像學分析[J]. 實用放射學雜志, 2013, 29(1):52-55, 76.

West China Medical Journal

CT Characteristics and Misdiagnosis Analysis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma

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