Subclinical focal cholangitis mimicking liver metastasis in asymptomatic patients with history of pancreatic ductal adenocarcinoma and biliary tree intervention

Table 1 Summary of focal cholangitis cases

Case	Sex	Age (years)	Symptoms	BTI	Interval between BTI and HL (days)	Laboratory abnormalities	CA 19.9 (U/mL) before / at diagnosis of HL	Imaging features	Outcome
1	F	57	None	BDA	558	None	17 / 19	CT (venous phase): ill-defined hypovascular lesion	Benign on LB and disappearance on FU
2	F	71	None	BDA	235	None	35 / 21	CT (biphasic): hypervascular nodule with target appearance in arterial and venous phases	Benign on LB and disappearance on FU
3	F	74	None	Papillotomy	99	None	34 / 38	CT (venous phase): hypovascular nodule (L1) and hypovascular ill-defined area (L2)	Disappearance on FU
4	M	69	None	BDA	479	None	52 / 18	MRI (triphasic): low SI on T1WI, high SI on T2WI, high SI on DWI, enhancement greater than liver background in all post contrast phases	Disappearance on FU
5	F	60	None	Stent	123	CA 19.9^a	63 / 74	CT (biphasic): hypovascular lesion with peripheral THAD MRI (triphasic): high SI on T1WI, intermediate SI on T2WI, high SI on DWI, hypovascular in all post contrast phases	Disappearance on FU
6	M	59	None	Stent	165	CA 19.9^b, AP^c	2156 / 1032	CT (biphasic): hypovascular nodule with target appearance in arterial and venous phases and peripheral THAD MRI (triphasic): low SI on T1WI, high SI on T2WI, high SI on DWI, hypovascular in all post contrast phases	Disappearance on FU

AP alkaline phosphatase, biphasic arterial and venous phases, BTI biliary tree intervention, CA cancer antigen, BDA biliodigestive anastomosis, DWI diffusion weighted imaging, FU follow-up, HL hepatic lesion, LB liver biopsy, L1 lesion 1, L2 lesion 2, SI signal intensity, THAD transient hepatic attenuation differences, triphasic: arterial, venous and delayed phases
^aCA 19.9: 74 U/mL (normal range: 0–37 U/mL)
^bCA 19.9: 1032 U/mL (normal range: 0–37 U/mL)
^cAP: 190 U/L (normal range: 45–129 U/L)

ISSN: 1470-7330