ソナゾイド造影超音波検査が肝内胆管癌の肝病変および腹膜播種の診断に有用であった一例

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  • Intrahepatic Cholangiocellular Carcinoma With Peritoneal Metastasis Diagnosed by Sonazoid Enhanced Ultrasonography
  • ソナゾイドゾウエイ チョウオンパ ケンサ ガ カン ナイタンカンガン ノ カン ビョウヘン オヨビ フクマク ハシュ ノ シンダン ニ ユウヨウ デ アッタ イチレイ

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A 51 year old man was referred to our hospital with ascites. Ultrasonography (US) and computed tomography (CT) detected an about 2cm tumor with unclear margins in the left lobe of the liver along with peritoneum tumors with ascites. Contrast-enhanced ultrasonography (CEUS) using Sonazoid was undertaken. CEUS imaging of Kupffer cells clearly showed the margin of the liver tumor. Clear enhancement was observed in the liver tumor and peritoneal tumors by vascular imaging. The findings indicated that the liver and peritoneal tumors had the same origin. Laparoscopic examination was performed to obtain histological findings. Specimens from the peritoneal tumor showed a tubular adenocarcinoma that was positive for cytokeratin 7 immunohistochemical staining, but negative for CK20, D2-40 and thrombomodulin staining. Based on these histological findings, these tumors were diagnosed as cholangiocarcinoma and metastasis to the peritoneum. CEUS using Sonazoid was found useful for observing both liver and peritoneal tumors.

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