Our topic now brings us
What does this mean?
Cholangio means gallbladder,
and the cancer of it. So we have a number
of diagnoses that have the term or prefix
cholangio, right? So
we had cholecystitis,
we had cholangitis.
This is cholangiocarcinoma. It is a
primary tumor of the biliary epithelium.
Let's talk about risk factors.
In micro, you learned about
a fluke called Clonorchis sinensis,
and ascariasis could be
parasitic infection of the biliary
tree resulting in sufficient
irritation in cholangiocarcinoma.
You quickly tell me about what
you’re going to find with
primary sclerosing cholangitis
upon imaging. Good.
Beaded appearance. Remember?
And what does your stool look
like in primary sclerosing?
Clay white. No pigmentation.
Multiple biliary, what's
known as papillomatosis,
and even choledochal cyst.
I just got done talking
to you about how congenitally,
with the choledochal cyst,
that becomes dangerous
because of stasis.
My topic is cholangiocarcinoma
Exposure to thorium, a thorotrast
used back in the ‘40s.
Usually, now, of historical
may be associated with
FAP, HNPCC, and males.
Remember, as far as you’re
concerned, familial adenomatous
polyposis, 100% risk of going on to
colorectal cancer, most likely left side.
Know that as being your
information number one.
Information or fact number
two that you want to know
with hereditary nonpolyposis
the patient may develop colorectal
cancer on the right side.
Because of either genetic
issues though,you'll never know,
you could have problems with
the gallbladder as well.
Diagnosis. Weight loss, jaundice and
pruritus with cancer of the gallbladder.
And there’s something called
a Klatskin tumor, at hilar confluence
causes what's known as
your palpable gallbladder,
a tumor that literally is going
to be at the confluence.
CT and MRCP may show ductal dilation,
intra or extra-hepatic masses
when dealing with cholangiocarcinoma.
This cancer can be anywhere
along your biliary tree.
Dangerous, very dangerous.
ERCP: Histologic sampling is not sensitive.
Surgery reserved for early, early cases.
Palliation, remember this, biliary
duct may then become narrowed.
You need to get in there and
make sure that you place a stent.
And chemo and radiotherapy, not useful.
If you don’t get in here early,
your patient's dead.
Increased mortality. Cholangiocarcinoma
is once again incredibly serious.