Biliary Metastases and Lymphoma

Published on 19/07/2015 by admin

Filed under Radiology

Last modified 19/07/2015

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 CT: Usually polyploid enhancing nodule or mass within GB lumen, but may appear as focal mural thickening

image MR: Melanoma classically hyperintense on T1WI and hypointense on T2WI
image US: Immobile polypoid mass (usually > 1.5 cm) ± adjacent GB wall thickening

– Melanoma classically described as hyperechoic, without acoustic shadowing
– May be single or multiple
– Flow characteristics variable on color Doppler, but usually evidence of internal flow
• Lymphoma of GB

image High-grade lymphomas often present as bulky mass (usually hypodense and homogeneous), while low-grade lymphomas cause only mild wall thickening
image Usually other evidence of lymphoma elsewhere, including adenopathy and splenomegaly
• Metastatic disease to biliary tree

image Indistinguishable from cholangiocarcinoma, including bile duct wall thickening, discrete soft tissue mass in porta hepatis, and proximal biliary dilatation/obstruction

PATHOLOGY

• Metastases to GB are rare, representing < 5% of all GB malignancies

image Melanoma accounts for 50-67% of GB metastases, with lung and renal malignancies also common
image Most patients with GB metastases have end-stage disease with widespread metastatic disease
image May rarely cause cholecystitis (due to cystic duct obstruction) or jaundice
• 

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