title: Primary extranodal non-Hodgkin's lymphoma of the common bile duct manifesting as obstructive jaundice: report of a case.
abstract: Primary non-Hodgkin's lymphoma (NHL) of the common bile duct (CBD) manifesting as obstructive jaundice is extremely rare: to our knowledge, only 22 cases of primary NHL arising from the CBD have been reported. The patient in this case report was a 63-year-old man who presented with obstructive jaundice. Abdominal sonography, positron emission tomography, and computed tomography showed a mass with abnormal 18-fluorodeoxyglucose uptake in pancreatic head. Magnetic resonance cholangiopancreatography demonstrated a strictured segment of the CBD with proximal bile duct dilatation. We performed pancreaticoduodenectomy for a presumptive diagnosis of pancreatic head carcinoma or cholangiocarcinoma of the CBD. However, the histological diagnosis was a primary, diffuse, large B-cell lymphoma of the CBD. He received three courses of combination chemotherapy, including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). The patient remains well, without evidence of tumor recurrence, 8 months after surgery. In summary, primary NHL of the CBD, despite its rarity, should be considered in the differential diagnosis of obstructive jaundice. An accurate histopathologic diagnosis and complete surgical resection, followed by combination chemotherapy plus rituximab may be effective.
authors.affiliation: Department of Surgery, Shikoku Cancer Center, Matsuyama, Ehime, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Dote
authors.forename: Koji
authors.initials: K
authors.lastname: Ohta
authors.forename: Rieko
authors.initials: R
authors.lastname: Nishimura
authors.forename: Norihiro
authors.initials: N
authors.lastname: Teramoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Asagi
authors.forename: Seijin
authors.initials: S
authors.lastname: Nadano
authors.forename: Makoto
authors.initials: M
authors.lastname: Hamada
authors.forename: Isao
authors.initials: I
authors.lastname: Yoshida
authors.forename: Takaya
authors.initials: T
authors.lastname: Kobatake
authors.forename: Isao
authors.initials: I
authors.lastname: Nozaki
authors.forename: Yoshirou
authors.initials: Y
authors.lastname: Kubo
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanada
authors.forename: Akira
authors.initials: A
authors.lastname: Kurita
authors.forename: Shigemitsu
authors.initials: S
authors.lastname: Takashima
mesh_terms: D003135:Common Bile Duct / Q000473:pathology* / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy