Biliary imaging: Klatskin tumour: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Biliary imaging: Klatskin tumour

Sample item

A 62-year-old man has painless jaundice. MRCP shows dilated intrahepatic ducts in both lobes with a collapsed gallbladder and a normal common bile duct below an abrupt stricture at the confluence of the hepatic ducts. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Hilar cholangiocarcinoma (Klatskin tumour)

A tumour at the confluence of the right and left hepatic ducts causes intrahepatic duct dilatation with a normal distal duct and a collapsed gallbladder. Bismuth-Corlette classification describes its extent.

Option by option

  • A. Carcinoma of the head of pancreas

    A pancreatic head tumour dilates the bile duct and the pancreatic duct with a distended gallbladder.

  • B. Choledocholithiasis

    A stone gives a filling defect and distal duct dilatation.

  • C. Pancreatic pseudocyst

    A pseudocyst is a peripancreatic fluid collection.

  • D. Hilar cholangiocarcinoma (Klatskin tumour) (correct)

    Correct. A stricture at the hepatic confluence with a normal distal duct defines hilar cholangiocarcinoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Hilar cholangiocarcinoma (Klatskin tumour). A tumour at the confluence of the right and left hepatic ducts causes intrahepatic duct dilatation with a normal distal duct and a collapsed gallbladder.

Why is "Carcinoma of the head of pancreas" not the answer?

A pancreatic head tumour dilates the bile duct and the pancreatic duct with a distended gallbladder.

Why is "Choledocholithiasis" not the answer?

A stone gives a filling defect and distal duct dilatation.

Why is "Pancreatic pseudocyst" not the answer?

A pseudocyst is a peripancreatic fluid collection.

What concept does this question test?

It tests Biliary imaging: Klatskin tumour in Radiology. Bismuth-Corlette classification describes its extent.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Biliary imaging: Klatskin tumour?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.