J Korean Radiol Soc.  1994 Jul;31(1):119-123.

Lymph Node Metastasis in the Biliary Tract Carcinoma: CT Evaluation

• Do YS
• Lee BH
• Kim KH
• Chin SY
• Lee AR

Abstract

PURPOSE
The primary biliary carcinoma is usually unresectable at presentation, because of early lymphatic spread. To determine the incidence and the spread pattern of lymph node metastases according to the location of the primary tumor, we analyzed the CT scans of the patients with primary biliary adenocarcinome.
MATERIALS AND METHODS
We reviewed the CT scans of 92 patients with pathologically proven primary biliary adenocarcinoma, including 45 peripheral cholangiocarcinomas, 22 hilar cholangiocarcinomas, 18 gallbladder carcinomas, and 7 common bile duct carcinomas. Positive adenopathy was diagnosed when the node exceeded 10 mm in short axis.
RESULTS
The overall incidence of nodal metastases was 59.8 % (55/92); 66.7 % in peripheral cholangiocarcinoma, 54.5 % in hilar cholangiocarcinoma, 55.6 % in gallbladder carcinoma, and 42.9 % in common bile duct carcinoma. The most commonly involved nodal group was the lesser omentum, followed by the celiac, periaortic, and peripancreatic group. The phrenic node group was only involved in the cases with the peripheral or hilar cholangiocarci nome.
CONCLUSION
The primary biliary carcinoma has a high incidence of lymph node metastases at the time of diagnosis, and shows different nodal spread pattern according to the location of the primary tumor. Involvement of the phrenic node was limited to the peripheral and hilar cholangiocarcinoma.

MeSH Terms

Adenocarcinoma
Axis, Cervical Vertebra
Biliary Tract*
Cholangiocarcinoma
Common Bile Duct
Diagnosis
Gallbladder
Humans
Incidence
Lymph Nodes*
Neoplasm Metastasis*
Omentum
Tomography, X-Ray Computed