PMC7342556_01
Preoperative radiological examination of the patient. Liver MRI (A) +PWI (B) +DWI (C) showed that the hepatic portal and retroperitoneal lymph nodes were enlarged.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging; DWI, diffusion-weighted imaging.
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The liver magnetic resonance imaging (MRI)+ perfusion-weighted imaging (PWI)+ diffusion-weighted imaging (DWI) re-examination on September 28, 2018 showed that the hepatic portal and retroperitoneal lymph nodes were enlarged, and tumor metastasis was considered (Figure 1).
Postoperative pathological examination of the patient. (A) stain: hematoxylin and eosin (H&E), original magnificationx100; (B) stain: H&E, original magnificationx200.
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Postoperative pathology suggested moderately/poorly differentiated adenocarcinoma (CCA) (Figure 2) that invaded the nerves, with 1/1 lymph node metastasis in 13 groups.
Postoperative radiological examination of the patient. Liver MRI (A) +PWI (B) +PWI (C) showed long T2-weighted signals indicating limited hepatic portal diffusion and heterogeneous enhancement.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging.
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T2-weighted signals, limited hepatic portal diffusion and heterogeneous enhancement was observed (0.7x0.6 cm), indicating metastatic lesions (Figure 3).
Radiological examination after combination therapy in the patient. Liver MRI (A) +PWI (B) +PWI (C) showed that the long T2-weighted signals in the hepatic portal disappeared, and hepatic portal and retroperitoneal lymph node enlargement were not observed.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging.
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The long T2-weighted signals in the hepatic portal disappeared, and hepatic portal and retroperitoneal lymph node enlargement was not observed (Figure 4).