Biliary Metastases and Lymphoma

 CT: Usually polyploid enhancing nodule or mass within GB lumen, but may appear as focal mural thickening


image MR: Melanoma classically hyperintense on T1WI and hypointense on T2WI

image US: Immobile polypoid mass (usually > 1.5 cm) ± adjacent GB wall thickening
– Melanoma classically described as hyperechoic, without acoustic shadowing

– May be single or multiple

– Flow characteristics variable on color Doppler, but usually evidence of internal flow


• Lymphoma of GB
image High-grade lymphomas often present as bulky mass (usually hypodense and homogeneous), while low-grade lymphomas cause only mild wall thickening

image Usually other evidence of lymphoma elsewhere, including adenopathy and splenomegaly

• Metastatic disease to biliary tree
image Indistinguishable from cholangiocarcinoma, including bile duct wall thickening, discrete soft tissue mass in porta hepatis, and proximal biliary dilatation/obstruction




PATHOLOGY




• Metastases to GB are rare, representing < 5% of all GB malignancies
image Melanoma accounts for 50-67% of GB metastases, with lung and renal malignancies also common

image Most patients with GB metastases have end-stage disease with widespread metastatic disease

image May rarely cause cholecystitis (due to cystic duct obstruction) or jaundice

• GB lymphoma represents only 0.1% of GB cancers
image Almost always secondary lymphomatous involvement, with primary GB lymphoma extraordinarily rare

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Nov 16, 2016 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on Biliary Metastases and Lymphoma

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