EASL Campus

A 45-years-old female diagnosed with primary sclerosing cholangitis (PSC) and no history of liver cirrhosis or inflammatory bowel disease (IBD) presents at the hepatological outpatient clinic for her annual surveillance. At abdominal ultrasound a solid mass, approximately 2 cm in size, is located in the right liver lobe. The mass has mixed hypo- and hyper echogenicity, with dilated bile ducts peripheral to the mass. The CA 19-9 was 60 U/ml (Ref 0-37 U/ml). Given the suspicion for intrahepatic cholangiocarcinoma (iCCA), further investigations are necessary.

Concerning the diagnostic and staging workup according to EASL guidelines on iCCA, which of the following statements is not true:

A. iCCA can be diagnosed non-invasively on imaging studies only, therefore the collection of tumor tissue samples for histo-pathology confirmation is not necessary

B. MRI should be considered over CT scanning for staging of iCCA within the liver

C. Patients with apparent resectable iCCA should undergo in addition to CT of thorax and abdomen also PET-CT for evaluation of extrahepatic disease

D. Patients with apparent resectable iCCA should undergo fine needle lymph node biopsy, if a positive result will alter management

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