Cholangiocarcinoma status post chemotherapy. ABDOMEN:LIVER, BILIARY TRACT: A common bile duct stent is noted with mild surrounding susceptibility artifact which limits evaluation. There is moderate intrahepatic biliary ductal dilatation to the level of the stent/Klatskin's point, appearing similar to the prior. There is subtle post-contrast circumferential enhancement about the proximal aspect of the stent (series 1008, 264), likely corresponding to the patients periductal infiltrating cholangiocarcinoma. There is subtle soft tissue infiltration into the porta hepatis where there is at least partial encasement of the common hepatic artery, measuring approximately 1.3 x 1.0 cm (series 1008/254).SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
The patient's known cholangiocarcinoma at Klatskin's point is difficult to accurately measure with subtle circumferential enhancement about the proximal aspect of the stent and soft tissue infiltration into the porta hepatis with at least partial encasement of the common hepatic artery. The appearance is similar to the recent prior CT (peri-arterial soft tissue is seen in retrospect on series 11 of image 95).