IHC

Question 1

MC Common Site for Cholangiocarcinoma

Answer 1

• 40% to 60% involve the biliary confluence
  (Klatskin tumor)
• 10% emanate from intrahepatic ducts and are known as IHC.

Question 2

most common risk factors for Cholangiocarcinoma

Answer 2

-primary sclerosing cholangitis
-choledochal cyst disease
-hepatolithiasis
-Recurrent Pyogenic Cholangitis.

Question 3

How it is Discovered ?

Answer 3

• Incidental
• Normal AFP
• Abnormal CEA and CA 19-9
• Diganosis of exclusion
• Do Upper and Lower Scopes
• CT Chest,Abd-Pelvis
• Bx may show Adenocarcinoma
• CT/MRI Focal lesion+ Biliary Dilatation

Question 4

CT Contrast HCC VS Cholangiocarcinoma ?

Answer 4

• peripheral or central enhancement on contrast-enhanced scans.
• unlike HCC there is persistent enhancement on delayed phases due to the fibrotic nature

in contrast with the vascular nature of HCC

Question 5

Factors associated with a poor outcome

Answer 5

• multifocality
• lymph node metastases
• vascular invasion
• positive margins

Question 6

Tx ?

Answer 6

Aim for R0 Resection

( Width of Margin not influenced the outcome )