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CT imaging of intrabiliary growth of colorectal liver metastases: a comparison of pathological findings of resected specimens

K Okano, MD1, J Yamamoto, MD2, T Okabayashi, MD1, Y Sugawara, MD1, K Shimada, MD1, T Kosuge, MD1, S Yamasaki, MD1, H Furukawa, MD3 and Y Muramatsu, MD3

Departments of 1 Surgery and 2 Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045 and 3 Department of Gastrointestinal Surgery, Cancer Institute Hospital, 1-37-1, Kami-ikebukuro, Toshima-ku, Tokyo 170-8455, Japan



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  		Figure 1. Liver metastases from sigmoid colon cancer in a 60-year-old man. (a) Unenhanced CT shows a peripherally located low density mass (T) and a low density area along the portal tract (arrowheads). (b)Enhanced CT shows enhancement of the peripheral tumour (T) and a thickened portal tract connected with the tumour as a high density area (arrowheads). (c) Photograph of the resected specimen shows a metastatic tumour located in segment V (Couinaud's nomenclature) and tumour growth in the bile duct (arrows) extending 31 mm from the tumour toward the right hepatic duct.

 


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  		Figure 2. Liver metastasis from descending colon cancer in a 72-year-old woman. (a) Enhanced CT shows a metastatic lesion as a low density mass and intrahepatic bile duct dilatation mainly in the posterior segment of the right hepatic lobe. (b) Contiguous CT section also shows intrahepatic bile duct dilatation and intrabiliary tumour growth (arrowheads) shown as a low density area along the route of the right hepatic duct. (c) Photograph of the resected specimen shows that the intrabiliary tumour (arrowheads) extended 14 mm from the tumour located in segment VI/VII into the right hepatic duct (stretched with threads).

 


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  		Figure 3. Liver metastases from sigmoid colon cancer in a 61-year-old man. (a) Enhanced CT shows a peripheral wedge-shaped high attenuation area in segment VIII. (b) Photograph of the resected specimen shows a metastatic tumour with intrabiliary tumour (arrowheads) that extended 15 mm proximally and distally.

 




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