title: Follicular lymphoma of the extrahepatic bile duct mimicking cholangiocarcinoma.
abstract: We report a case of a 33-year old man who presented with symptoms and signs of an acute biliary tract obstruction with jaundice and abdominal pain. Diagnostic imaging studies revealed a biliary stricture of the hepatic confluence, and a mass at the hepatic hilum which obstructed the extrahepatic bile duct from the outside. At laparotomy, there was 3-cm-size nodule at the hilum which presented with a rubbery consistency. We performed extrahepatic bile duct resection and right and left hepaticojejunostomy. Histological examination of the resected specimen revealed follicular lymphoma, which consisted of medium cleaved follicle-like cells, grade 1 of 3 according to the revised European-American classification of lymphoid neoplasms proposed by International Lymphoma Study Group. Postoperative follow-up of more than 1 year has been completely uneventful, without any symptoms or signs of disease recurrence. This is the second case report of follicular lymphoma of the extrahepatic bile duct.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
authors.forename: Koji
authors.initials: K
authors.lastname: Oda
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishio
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nimura
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D011171:Portoenterostomy, Hepatic