The MR Imaging of Primary Intrahepatic Lymphoepithelioma-like Cholangiocarcinoma: A Diagnostic Challenge

作者全名："Liu, Yangyang; Guo, Dajing; He, Xiaojing; Liu, Xi; Chen, Weijie; Chen, Lingli; Ji, Yuan; Zeng, Mengsu; Wang, Mingliang"

作者地址："[Liu, Yangyang; Guo, Dajing; He, Xiaojing; Liu, Xi] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Chen, Weijie] Chongqing Med Univ, Dept Gastroenterol, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Chen, Lingli; Ji, Yuan] Fudan Univ, Zhongshan Hosp, Shanghai Geriatr Med Ctr, Dept Pathol, Shanghai 200032, Peoples R China; [Zeng, Mengsu; Wang, Mingliang] Fudan Univ, Zhongshan Hosp, Shanghai Geriatr Med Ctr, Dept Radiol, Shanghai 200032, Peoples R China"

通信作者："Wang, ML (通讯作者)，Fudan Univ, Zhongshan Hosp, Shanghai Geriatr Med Ctr, Dept Radiol, Shanghai 200032, Peoples R China."

来源：DIAGNOSTICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001077214000001

JCR分区：Q1

影响因子：3

年份：2023

卷号：13

期号：18

开始页：　

结束页：　

文献类型：Article

关键词：intrahepatic lymphoepithelioma-like cholangiocarcinoma; magnetic resonance imaging; imaging features; EBV infection

摘要："Purpose: To characterize the magnetic resonance imaging features of primary intrahepatic lymphoepithelioma-like cholangiocarcinoma (LELCC). Materials and Methods: Thirty-four patients with 38 histologically confirmed LELCCs were enrolled retrospectively from January 2014 to August 2022. We evaluated the clinical features, histologic findings, and imaging manifestations on dynamic enhanced MRI. Results: 74% (25/34) of the cases were associated with EBV infection. Moreover, patients infected with EBV exhibited a lower level of Ki-67 proliferation. The serum CA199 level was elevated in 10 patients. The median tumor diameter was 2.8 cm (range, 1.1-8.7 cm). Most tumors were well-defined with a smooth or lobulated margin and showed peripheral hyperintensity and central hypointensity on T2-weighted imaging (T2WI). T2 hyperintense foci were recognized in 8 patients. In the dynamic enhanced MRI, 21 tumors demonstrated Type A enhancement pattern (rim enhancement), 10 demonstrated Type B (rapid wash-in and wash-out), and seven demonstrated Type C (rapid wash-in without wash-out). Capsular enhancement in PVP or DP was found in 22 tumors. A few patients had satellite lesions, portal vein thrombosis, bile duct dilatation, and distal metastasis. Lymph node metastases were discovered pathologically in 11 patients. Conclusions: MRI findings of LELCC vary and are non-specific. While a majority of LELCCs exhibit typical features of intrahepatic cholangiocarcinoma (iCCA), unique findings like T2 hyperintense foci or capsular enhancement could suggest LELCC. EBV infection and elevated tumor markers can aid in differentiation. However, given the mimics of some cases of liver hypervascular lesions, histological examination remains essential for definitive diagnosis."

基金机构：Chongqing Medical Scientific Research Project (a Joint project of the Chongqing Health Commission and Science and Technology Bureau) [2023QNXM029]

基金资助正文："This research was founded by the Chongqing Medical Scientific Research Project (a Joint project of the Chongqing Health Commission and Science and Technology Bureau), grant number 2023QNXM029."