title: Resected case of eosinophilic cholangiopathy presenting with secondary sclerosing cholangitis.
abstract: Eosinophilic cholangiopathy is a rare condition characterized by eosinophilic infiltration of the biliary tract and causes sclerosing cholangitis. We report a patient with secondary sclerosing cholangitis with eosinophilic cholecystitis. A 46-year-old Japanese man was admitted to our hospital with jaundice. Computed tomography revealed dilatation of both the intrahepatic and extrahepatic bile ducts, diffuse thickening of the wall of the extrahepatic bile duct, and thickening of the gallbladder wall. Under the diagnosis of lower bile duct carcinoma, he underwent pylorus-preserving pancreatoduodenectomy and liver biopsy. On histopathological examination, conspicuous fibrosis was seen in the lower bile duct wall. In the gallbladder wall, marked eosinophilic infiltration was seen. Liver biopsy revealed mild portal fibrosis. He was diagnosed as definite eosinophilic cholecystitis with sclerosing cholangitis with unknown etiology. The possible etiology of sclerosing cholangitis was consequent fibrosis from previous eosinophilic infiltration in the bile duct. The clinicopathological findings of our case and a literature review indicated that eosinophilic cholangiopathy could cause a condition mimicking primary sclerosing cholangitis (PSC). Bile duct wall thickening in patients with eosinophilic cholangitis might be due to fibrosis of the bile duct wall. Eosinophilic cholangiopathy might be confused as PSC with eosinophilia.
authors.affiliation: Department of Surgery, Teikyo University, School of Medicine, Tokyo, 173-8605, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Takehide
authors.initials: T
authors.lastname: Asano
authors.forename: Hodaka
authors.initials: H
authors.lastname: Amano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Toyota
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kato
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Junichi
authors.initials: J
authors.lastname: Fukushima
authors.forename: Fukuo
authors.initials: F
authors.lastname: Kondo
authors.forename: Hajime
authors.initials: H
authors.lastname: Takikawa
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D002761:Cholangitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome