Presentation
Jaundice and unintentional 15lbs weight loss.
Patient Data
There is diffuse moderate intrahepatic bile duct dilation. There is an enhancing soft tissue density within the common hepatic duct with post-focal dilation of the CBD measuring 1.0 cm with remaining duct being normal in caliber. Findings are concerning for neoplastic disease (Klatskin's tumor).
Non-dilated sludge filled gallbladder. No pancreatic lesion or duct dilation.
Sternotomy wires. Cardiac pacemaker/AICD lead. Moderate aortic valve and severe coronary artery calcifications.
Multiple internal/central fluid density within the right iliopsoas muscle, with a small focus of air. No peripheral enhancement. Findings favor ruptured iliopsoas bursa or liquefied hematoma versus less likely abscess.
Small hiatal hernia.
Infrarenal IVC filter.
Diffuse aortic calcifications.
Evidence for constipation.
There is an enhancing soft tissue density within the common hepatic duct (open arrow).
Case Discussion
ERCP bile duct brush cytology: Positive for malignant cells; adenocarcinoma.
CA 19-9: 2211 U/ml
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