The CT and MRI Features of Primary Intrahepatic Lymphoepithelioma-Like Cholangiocarcinoma.

Abstract

<b>OBJECTIVE.</b> The purpose of our study was to retrospectively characterize the CT and MRI features of primary intrahepatic lymphoepithelioma-like cholangiocarcinoma (LELCC). <b>MATERIALS AND METHODS.</b> Eleven patients (10 women and one man; age range, 30-63 years) with 11 pathologically proven LELCCs were enrolled retrospectively from April 2016 to December 2018. Triphasic enhanced images were obtained of all patients: MR images of five patients, CT images of five patients, and both CT and MR images of one patient. The clinical data and CT and MRI findings were reviewed. <b>RESULTS.</b> All LELCC cases were associated with Epstein-Barr virus (EBV) infection. Eight of the 11 patients had hepatitis B virus (HBV) infection. The tumor diameter ranged from 1.1 to 8.7 cm. All tumors were well defined with a smooth or lobulated margin. A cystic area was noted in two of the 11 tumors. After the administration of contrast material, the tumors showed homogeneous (<i>n</i> = 7) or heterogeneous (<i>n</i> = 4) hypervascular arterial enhancement and gradual washout, delayed central scar or irregular enhancement (<i>n</i> = 9), delayed circular thin or incomplete pseudocapsule enhancement (<i>n</i> = 7), and homogeneous hypointensity in the hepatobiliary phase (<i>n</i> = 2). No cirrhosis, focal dilatation of intrahepatic ducts, or satellite nodules were detected. Lymphadenopathy were detected in four patients, appearing as hypervascular enhancement and no necrosis (even in multiple nodes > 3 cm) or as moderate peripheral enhancement and necrosis. <b>CONCLUSION.</b> A liver mass in a middle-aged woman with EBV and HBV infection that appears on CT and MRI to have a well-defined boundary and a combination of hypervascularity, washout, delayed intratumoral enhancement, or pseudocapsule enhancement may suggest an imaging diagnosis of primary LELCC. More cases are needed to better understand this disease.