- A Small Hepatocellular Carcinoma Invading the Intrahepatic Duct Confirmed by Percutaneous Transhepatic Cholangioscopy
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Byoung Wook Bang, Seok Jeong, Yong Sun Jeon, In Suh Park, Don Haeng Lee, Jung Il Lee, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Young Soo Kim, Jin-Woo Lee
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Journal of the Korean Liver Cancer Study Group. 2008;8(1):74-76. Published online June 30, 2008
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Abstract
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- A hepatocellular carcinoma (HCC) invading the bile duct is an uncommon form and sometimes difficult to
differentiate from cholangiocarcinoma. Because of different treatment modality, differential diagnosis of thesetwo
diseases should be performed. We experienced an unusual case with HCC with obstructive jaundice caused by the
involvement of intrahepatic duct, then confirmed by percutaneous transhepatic cholangioscopic biopsy results. A
60-year-old man was admitted with fever, chills, and an epigastric pain of 5 days duration. The patient had
compensated liver cirrhosis as a result of alcohol abuse. Multidetector computed tomography (MDCT) of the
abdomen revealed a low attenuated mass associated with bile duct dilation at the fourth segment of the liver. The
cholangioscopic finding showed a single, 2-cm, polypoid mass with a yellowish ‘‘chicken fat-like’’ appearance,
protruding into the lumen of the fourth branch of the left intrahepatic duct and bleeding easily. A diagnosis of
HCC was proven by microscopic examination of the tissue specimen obtained by a cholangioscopic biopsy.
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