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The MR Imaging of Primary Intrahepatic Lymphoepithelioma-like Cholangiocarcinoma: A Diagnostic Challenge.
Liu, Yangyang; Guo, Dajing; He, Xiaojing; Liu, Xi; Chen, Weijie; Chen, Lingli; Ji, Yuan; Zeng, Mengsu; Wang, Mingliang.
Affiliation
  • Liu Y; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
  • Guo D; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
  • He X; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
  • Liu X; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
  • Chen W; Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
  • Chen L; Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai Geriatric Medical Center, Shanghai 200032, China.
  • Ji Y; Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai Geriatric Medical Center, Shanghai 200032, China.
  • Zeng M; Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Geriatric Medical Center, Shanghai 200032, China.
  • Wang M; Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Geriatric Medical Center, Shanghai 200032, China.
Diagnostics (Basel) ; 13(18)2023 Sep 20.
Article in En | MEDLINE | ID: mdl-37761365
ABSTRACT

PURPOSE:

To characterize the magnetic resonance imaging features of primary intrahepatic lymphoepithelioma-like cholangiocarcinoma (LELCC). MATERIALS AND

METHODS:

Thirty-four patients with 38 histologically confirmed LELCCs were enrolled retrospectively from January 2014 to August 2022. We evaluated the clinical features, histologic findings, and imaging manifestations on dynamic enhanced MRI.

RESULTS:

74% (25/34) of the cases were associated with EBV infection. Moreover, patients infected with EBV exhibited a lower level of Ki-67 proliferation. The serum CA199 level was elevated in 10 patients. The median tumor diameter was 2.8 cm (range, 1.1-8.7 cm). Most tumors were well-defined with a smooth or lobulated margin and showed peripheral hyperintensity and central hypointensity on T2-weighted imaging (T2WI). T2 hyperintense foci were recognized in 8 patients. In the dynamic enhanced MRI, 21 tumors demonstrated Type A enhancement pattern (rim enhancement), 10 demonstrated Type B (rapid wash-in and wash-out), and seven demonstrated Type C (rapid wash-in without wash-out). Capsular enhancement in PVP or DP was found in 22 tumors. A few patients had satellite lesions, portal vein thrombosis, bile duct dilatation, and distal metastasis. Lymph node metastases were discovered pathologically in 11 patients.

CONCLUSIONS:

MRI findings of LELCC vary and are non-specific. While a majority of LELCCs exhibit typical features of intrahepatic cholangiocarcinoma (iCCA), unique findings like T2 hyperintense foci or capsular enhancement could suggest LELCC. EBV infection and elevated tumor markers can aid in differentiation. However, given the mimics of some cases of liver hypervascular lesions, histological examination remains essential for definitive diagnosis.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies Language: En Journal: Diagnostics (Basel) Year: 2023 Document type: Article Affiliation country: China

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies Language: En Journal: Diagnostics (Basel) Year: 2023 Document type: Article Affiliation country: China