Differential Diagnosis for PET Negative Biliary Duct Liver Hilum Mass
Single Most Likely Diagnosis
- Cholangiocarcinoma: This is the most common malignancy of the biliary duct and can present as a mass in the liver hilum. Although it is PET negative, cholangiocarcinoma can be slow-growing and may not always exhibit high metabolic activity.
Other Likely Diagnoses
- Hilar lymphadenopathy: Enlarged lymph nodes in the hilar region can mimic a mass and may be due to various causes such as infection, inflammation, or metastasis from other cancers.
- Bile duct stricture or stenosis: A benign stricture or stenosis of the bile duct can cause a mass-like appearance in the liver hilum, especially if there is associated inflammation or fibrosis.
- Intraductal papillary neoplasm of the bile duct (IPNB): A rare tumor that grows within the bile ducts and can cause a mass in the liver hilum.
Do Not Miss Diagnoses
- Gallbladder cancer with direct extension: Although less common, gallbladder cancer can directly extend into the liver hilum and cause a mass. Missing this diagnosis could be deadly due to the aggressive nature of gallbladder cancer.
- Lymphoma: Both primary and secondary lymphoma can involve the liver hilum and present as a mass. Lymphoma requires prompt diagnosis and treatment to improve outcomes.
- Metastasis from other primary cancers: Metastases from other primary cancers, such as pancreatic, gastric, or colorectal cancer, can involve the liver hilum and present as a mass.
Rare Diagnoses
- Biliary cystadenoma or cystadenocarcinoma: Rare benign or malignant tumors of the bile duct that can present as a cystic mass in the liver hilum.
- Granulomatous disease (e.g., sarcoidosis, tuberculosis): Rare inflammatory conditions that can cause granulomatous involvement of the liver hilum and mimic a mass.
- Hepatic artery aneurysm: A rare vascular anomaly that can present as a mass in the liver hilum, especially if it is thrombosed or contains calcifications.