Extrahepatic cholangiocarcinoma associated with clonorchiasis: CT evaluation

BACKGROUND: I evaluated the computed tomographic (CT) features of nine pathologically proven cases of cholangiocarcinoma in the extrahepatic bile duct associated with clonorchiasis. METHODS: CT scans of nine pathologically proven cholangiocarcinoma associated with clonorchiasis were reviewed retrospectively. CT scans were analyzed for the following parameters: tumor (detection, location, gross morphologic type, contrast enhancement), intrahepatic bile duct (dilatation, pattern of dilatation), common bile duct (dilatation, Clonorchis sinensis worms), gallbladder (inflammation, C. sinensis worms), invasion of the contiguous viscera (pancreas, duodenum, liver), lobar atrophy, and lymphadenopathy and metastasis. RESULTS: CT depicted the level and cause of obstruction in all nine patients (100%). Contrast enhancement of the tumors relative to the liver parenchyma showed isoattenuation in five tumors (55%) and hyperattenuation in four tumors (44%). Severe, uniform dilatation of the intrahepatic bile duct was identified in six patients (67%) and central dilatation was seen in two patients (22%). No evidence of dilatation of the intrahepatic bile duct was seen in one patent (11%). Most tumors were located in the proximal third of the extrahepatic bile duct ( n = 7, 78%). Male preponderance was found ( n = 8, 89%). CONCLUSION: Cholangiocarcinoma associated with clonorchiasis was located predominantly in the proximal third of the extrahepatic bile duct and detected more readily than nonclonorchiasis-associated cholangiocarcinoma.