Professional Documents
Culture Documents
(CHOLANGIOCARCINOMA)
I N TAN K I N A N T I
201520401011144
H-25
PENDAHULUAN
Jaundice
Faeces berwarna kuning dempul
Urin berwarna gelap
Pruritus
Rasa sakit pada perut kuadran kanan atas (abdomen) dengan
rasa sakit yang menjalar ke punggung.
Penurunan berat badan
PEMERIKSAAN PENUNJANG
CT-Scan
ERCP (ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY)
MAGNETING RESONANCE IMAGING DAN
MAGNETING RESONANCE
CHOLANGIOPANCREATOGRAPHY
Hilar cholangiocarcinoma (Klatskin tumor).
(A) Axial Spoiled Gradient Echo T1-
weighted image shows a hypointense
lesion in the left lobe, with infiltrating
grow pattern.
(B) On Half Fourier RARE T2-weighted
image, the lesion appears hypointense
to adjacent liver parenchyma. The
lesion infiltrates the intrahepatic bile
duct of the left lobe with
upstreamdilation. On dynamic T1-
weighted Spoiled Gradient Echo, the
lesion appears hypovascular compared
with adjacent liver parenchyma
(C), with progressive enhancement
during the portal venous phase
(D), reaching a peak during the delayed
phase (E).
(F) Delayed contrast enhancement can
be better appreciated on coronal fat-
suppressed, Spoiled Gradient Echo T1-
weighted images; coronal imaging is
also well-suited to assess portal vein
encasement.
(G) Coronal thick-slab Half Fourier
RARE MRCP shows a type IIIB
infiltration of the bile duct, according to
Bismuth.
e. Endosonography with fine-needle aspiration
Evaluasi lebih lanjut terhadap kelenjar limfe regional dan
percabangan biliaris untuk informasi staging dan aspirasi
jaringan untuk analisa patologik. Penggunaan teknik ini
untuk mendapatkan jaringan dari lesi hillar yang
mencurigakan tidak disarankan karena dapat menyebabkan
penyebaran tumor dengan peritoneal tumor seeding.