caa a22 4500 605493197 CHVBK 20210128100519.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0480-2 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0480-2 Intrahepatic cholangiocarcinomas mimicking other lesions [Elektronische Daten] [Sharon Adam, Sudharshan Parthasarathy, Frank Miller] Background: While the typical features of large cholangiocarcinomas have been described extensively and are known to radiologists, atypical cholangiocarcinomas are not as well known and radiologists should be more aware of their features. Due to the increasing numbers of cross-sectional imaging studies performed for various reasons, cholangiocarcinomas may be more frequently detected incidentally when small, before they become symptomatic, and might be mistaken for other liver lesions. We studied the appearance of misdiagnosed cholangiocarcinomas. Materials and methods: This is a HIPAA-compliant, IRB-approved retrospective study. Our institutional database and teaching files were searched for cases of cholangiocarcinomas diagnosed between 2004 and 2014 that were initially misdiagnosed or considered indeterminate lesions on MRI or CT. Clinical data and radiological findings were collected. History of malignancy and risk factors for cholangiocarcinoma were recorded. The initial reported diagnosis and time to the correct diagnosis were noted, and the lesions were evaluated for size, enhancement, T1/T2 signal, diffusion restriction, ADC value, capsular retraction, biliary dilatation and the presence of satellite nodules. Results: Nine examples of cholangiocarcinoma that met our inclusion criteria were identified: seven men and two women. All were small, with a mean size of 2.2cm upon initial diagnosis. All showed a hypervascular pattern of enhancement without washout. Imaging features that are described in the literature as typical for cholangiocarcinomas, such as capsular retraction, satellite nodules, and peripheral biliary dilatation, were not seen. Conclusion: Cholangiocarcinomas can be misdiagnosed when they are small and hypervascular. This atypical hypervascular appearance is rare, and may mimic benign liver lesions and other malignant lesions, especially when small. Awareness of the confounding imaging features of these tumors should lead to a more meticulous evaluation of small hypervascular lesions, and may minimize the risk of misdiagnosing early-stage cholangiocarcinomas. Springer Science+Business Media New York, 2015 Cholangiocarcinoma nationallicence Hypervascular nationallicence Liver nationallicence Magnetic resonance imaging nationallicence Computed tomography nationallicence Adam Sharon Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut Parthasarathy Sudharshan Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut Miller Frank Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2345-2354 0942-8925 40:7<2345 2015 40 261 https://doi.org/10.1007/s00261-015-0480-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0480-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Adam Sharon Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Parthasarathy Sudharshan Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut NATIONALLICENCE 700 1- Miller Frank Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676 North Saint Clair Street, Suite 800, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2345-2354 0942-8925 40:7<2345 2015 40 261