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Journal of the Korean Liver Cancer Study 2008;8(1):74-76.
Published online June 30, 2008.
A Small Hepatocellular Carcinoma Invading the Intrahepatic Duct Confirmed by Percutaneous Transhepatic Cholangioscopy
Byoung Wook Bang1, Seok Jeong1, Yong Sun Jeon2, In Suh Park3, Don Haeng Lee1, Jung Il Lee1, Kye Sook Kwon1, Hyung Gil Kim1, Yong Woon Shin1, Young Soo Kim1, Jin-Woo Lee1
1Departments of Internal Medicine, Inha University College of Medicine, Incheon, Korea
2Departments of Radiology, Inha University College of Medicine, Incheon, Korea
3Departments of Pathology, Inha University College of Medicine, Incheon, Korea
Correspondence:  Jin-Woo Lee,
Email: jin@inha.ac.kr
Copyright ©2008 by The Korean Liver Cancer Association
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.
Key Words: Hepatocellular carcinoma; Cholangioscopy; Biliary tract neoplasm


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