A CASE LOCALIZED INFLAMMATORY BILIARY STENOSIS MIMICKING BILE DUCT CANCER

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  • KURATAKE Shinji
    Department of Surgery, Tokushima Prefectural Miyoshi Hospital
  • YOSHIDA Sadahiro
    Department of Surgery, Tokushima Prefectural Miyoshi Hospital
  • YATA Seigo
    Department of Surgery, Tokushima Prefectural Miyoshi Hospital
  • YOGITA Shiro
    Department of Surgery, Tokushima University School of Medicine
  • TASHIRO Seiki
    Department of Surgery, Tokushima University School of Medicine

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  • 肝門部胆管癌と鑑別が困難であった限局性炎症性胆道狭窄の1例

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A case of localized inflammatory biliary stenosis which presented difficulty in differentiation from bile duct cancer is reported. A 66-year-old man was admitted to the hospital because he was pointed out elevations in biliary enzymes at blood biochemical analysis. No anemia nor jaundice was noted. No abdominal tumor was palpated. Abdominal CE-CT revealed a dense tumor shadow at the hepatic hilar region. Endoscopic retrograde cholangio-pancreatography (ERCP) revealed a stenosis covering from the left the and right hepatic ducts to common hepatic duct. Abdominal angiography visualized a faint accumulation of a contrast material where corresponded to the tumor. With a diagnosis of bile duct cancer at the hepatic hilar region, a resection of central two segments of liver and a total resection of caudate lobe were performed. Histopathologically, no malignancy was confirmed, and infiltration of inflammatory cells mainly comprizing of lymphocytes and plasmacytes and proliferation of fibroblasts were demonstrated in the vicinity of the bile duct. It was chronic inflammatory stenosis of the dile duct.<br> It is etiologically suggested that the biliary stenosis in this case might be unlikely caused by secondary sclerotic cholangitis due to bacterial ascending cholangitis, but likely by localixed primary sclerotic cholangitis (PSC), that is a specific type of PSC.

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