Cholangiocarcinoma that infiltrated a Periampullary Duodenal Diverticula and the head of the pancreas (11 of 20)

An inverted picture of tumor showing the duodenal,
diverticular and pancreatic relations

Large solitary tumors are characteristic of peripheral
cholangiocarcinoma; however, a multinodular type may
occur. These tumors have a fibrous stroma, are firm and
grayish white in color, and are not well vascularized. Hilar
cholangiocarcinoma are usually firm, intramural, annular
tumors that encircle the bile duct, or may be bulky hard
masses that are on the duct or hilar region and extend into
the liver. They may also appear as a spongy friable mass
in the lumen of the bile duct. There may be metastatic
nodules throughout the liver with dilation of bile ducts
peripheral to the mass.