Cystic dilatation as a radiographic sign of cholangiocarcinoma complicating sclerosing cholangitis.

A 40-year-old woman with ulcerative colitis and sclerosing cholangitis developed jaundice unresponsive to steroids. Endoscopic retrograde cholangiopancreatography showed multiple cystic dilatations similar in appearance to a previous report of a patient with sclerosing cholangitis who had an associated cholangiocarcinoma. Subsequent laparotomy led to the diagnosis of a cholangiocarcinoma. We conclude that the presence of cystic dilatation on cholangiography in patients with sclerosing cholangitis is highly suggestive of an associated cholangiocarcinoma.