Gallbladder carcinoma with porta-hepatis metastatic lymphadenopathy and obstructive jaundice
55 years old female with right upper quadrant abdominal pain and jaundice.
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- The gall bladder shows diffusely thickened irregular wall and soft tissue density formation at its fundus measuring 2.7 X 1.3 cm. No definite radio-dense stones thee within.
- Mild fluid collection is seen around the gall bladder with pericholecystic fat stranding.
- A partially ill-defined hypodense mass lesion is seen filling the porta hepatis region encasing the hepatic artery and portal vein (which are still patent) as well as constricting the CBD. It shows faint post-contrast enhancement. it measures 6.3 X 4.4 cm.
- No pancreatic focal lesions.
- Consequent central moderate intra-hepatic biliary tree dilatation.
- Multiple enlarged para-aortic and gastro-hepatic lymph nodes are also seen, the largest is 1.9 X 1.6 cm.
- The liver is otherwise, of normal size with no hepatic parenchymal focal lesions.
Gall bladder soft tissue mass with porta hepatis, gastro-hepatic and para-aortic lymphadenopathy consistent with gall bladder carcinoma and metastatic lymph nodal deposits as well as consequent central intra-hepatic biliary tree dilatation. This case shows obstructive jaundice due to metastatic porta-hepatis lymphadenopathy.
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