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Cholangiocarcinoma may be associated with recurrent pyogenic cholangitis as a complication of longstanding proliferative cholangitis in the presence of intrahepatic stones. Sonographic and CT findings of six patients with cholangiocarcinoma of the liver associated with recurrent pyogenic cholangitis are presented. The cases were among 128 patients who underwent partial resection of the liver because of recurrent pyogenic cholangitis and its complication. On sonogram the mass was depicted in four patients as an ill-defined heterogenously echogenic mass and in one patient as a bulging contour; in the remaining one case the mass was not detected. There were small or large, shadowing or nonshadowing stones within the tumor in five cases. In one case, the stone was in the duct proximal to the tumor. On CT scans of four patients, the tumors were depicted as an ill-defined, irregular low attenuation masses with variable contrast enhancement, the periphery being more enhanced. The st nes were demonstrated in four cases, including three cases in which stones were within the tumor. Cholangiocarcinoma should be considered as a differential diagnosis in patients with recurrent pyogenic cholangitis who presents with a hepatic mass containing stones.
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