PMC3823417_01
MRI (coronal view) of the abdomen showing the distended gallbladder (arrow) with multiple stones.
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MRI with contrast revealed a hypointense left hepatic lobe mass measuring 5.3 cm (craniocaudad) x 4.2 cm (AP) x 5.3 cm (transverse) with heterogenous and hyperintense T2 signal on T2 weighted sequences; an enlarged gallbladder (12.2x6x6.4 cm) with cholelithiasis without pericholecystic fluid (Figures 1 and 2).
MRI (axial view) of the abdomen showing the left hepatic lobe mass (white arrow).
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MRI with contrast revealed a hypointense left hepatic lobe mass measuring 5.3 cm (craniocaudad) x 4.2 cm (AP) x 5.3 cm (transverse) with heterogenous and hyperintense T2 signal on T2 weighted sequences; an enlarged gallbladder (12.2x6x6.4 cm) with cholelithiasis without pericholecystic fluid (Figures 1 and 2).
MRCP of the biliary tree showing the narrowing on the mid common bile duct (arrow).
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MRCP revealed intrahepatic biliary ductal dilation measuring approximately 1 cm with abrupt short segment narrowing in the extrahepatic common bile duct measuring 0.2 cm in diameter ( Figure 3).
Needle biopsy of the liver tumor showing high-grade carcinoma (H&E, x200).
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CT-guided liver biopsy was obtained and histopathological exam revealed high-grade carcinoma ( Figure 4).
Needle biopsy of the liver tumor stained with cytokeratin CK 7 (x200).
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Epithelial nature was confirmed by positive stains for cytokeratins ( Figure 5).
Poorly differentiated bile duct carcinoma (arrow) invading through the bile duct wall (H&E, x40).
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Histopathological examination revealed chronic cholecystitis with cholelithiasis, invasive poorly differentiated adenocarcinoma involving common bile duct, cystic duct and gallbladder neck (Figure 6).
Metastasis of the tumor in a lymph node. Tumor is shown in the left part invading the lymph node (H&E, x200).
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Metastases were identified in the portal lymph nodes (Figure 7).