Primary Bile Duct Diffuse Large B-cell Lymphoma Diagnosed by Repeated Endoscopic Ultrasound-guided Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography

• Published in: Internal Medicine Vol. 63; no. 4; pp. 493 - 501
• Main Authors: Imai, Yurika, Sekine, Masanari, Aoyama, Kayoko, Kojima, Shu, Sasaki, Goya, Sato, Azumi, Matsumoto, Keita, Morino, Mina, Kashima, Hitomi, Koito, Yudai, Miura, Takaya, Takahashi, Yuko, Ishii, Takehiro, Tsuboi, Rumiko, Otake, Haruka, Yoshikawa, Shuhei, Uehara, Takeshi, Asano, Takeharu, Matsumoto, Satohiro, Miyatani, Hiroyuki, Oshiro, Hisashi, Mashima, Hirosato
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.02.2024; Japan Science and Technology Agency
• Subjects: B-cell lymphoma; bile duct; Bile ducts; Bile Ducts - pathology; Biopsy; Case Report; Cholangiopancreatography, Endoscopic Retrograde - methods; Cholestasis; Computed tomography; Constriction, Pathologic; Diagnosis; diffuse large B-cell lymphoma; Endoscopic Ultrasound-Guided Fine Needle Aspiration; ERCP; EUS-FNA; Humans; Jaundice; Jaundice, Obstructive - etiology; Lymphocytes B; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Male; Middle Aged; obstructive jaundice; Pancreatic Neoplasms - pathology; Stricture; Ultrasound; bile duct; ERCP; diffuse large B-cell lymphoma; obstructive jaundice; EUS-FNA
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.1776-23

A 54-year-old man was admitted with obstructive jaundice. Computed tomography showed common bile duct stricture and a tumor around the celiac artery. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) as well as a laparotomic biopsy around the celiac artery were diagnostically unsuccessful. Since the bile duct stricture progressed, EUS-FNA and ERCP were performed a third time, finally leading to the diagnosis of diffuse large B-cell lymphoma. The treatment plan and prognosis of obstructive jaundice differ greatly depending on the disease. It is important to conduct careful follow-up and repeated histological examinations with appropriate modifications until a diagnosis is made.