Male 69 years old Reason: evaluate for cholangiocarcinoma History: abnormal CT scan ABDOMEN:LIVER, BILIARY TRACT: Liver morphology is normal with mild atrophy of the left hepatic lobe. There is a T2 hypointense mass at the confluence of the left and right hepatic ducts with greater extension into the left hepatic ducts. The mass shows restricted diffusion and enhancement on delayed imaging. It measures 1.7 x 2.1 cm. The lesion extends more into the left hepatic ducts causing more proximal ductal obstruction. The lesion obstructs the central right hepatic lobe common duct.There is moderate to severe intrahepatic biliary ductal dilation. There is an accessory right hepatic duct The lesion obstructs the left portal vein which is thrombosed. Right portal vein is patent.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: Small peripancreatic and hilar nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.2.0 cm Klatskin point tumor with predominant extension into the left hepatic ducts with imaging features compatible with a cholangiocarcinoma with predominant fibrous stroma.2.Moderate to severe intrahepatic biliary ductal dilatation. The left hepatic lobe ducts are obstructed more to the periphery of the liver leading to isolated areas of ductal obstruction. The right hepatic lobe ducts are obstructed more centrally.3.Invasion of the left portal vein by tumor.