title: [A case of macroscopically unvisualized mucin-hypersecreting biliary papillomatosis diagnosed by microscopy].
abstract: The mucin-hypersecreting biliary papillomatosis is a premalignant neoplasm characterized by intraductal papillary proliferation involving extensive areas of the intrahepatic and/or extrahepatic bile duct. We report a case of mucin-hypersecreting biliary papillomatosis manifested as obstructive jaundice and diagnosed only by microscopy, with a review of literatures. A 74-year-old female, who had a past history of cholecystectomy about 13 years ago, was admitted to our hospital with jaundice. A CT scan showed marked dilatation of intrahepatic and extrahepatic bile duct without intraductal filling defect or extrabiliary mass. During endoscopic retrograde cholangiopancreatography, mucin extrusion from the duodenal major papilla and dilated common bile duct with amorphous filling defects was noted. Percutaneous transhepatic biliary drainage for cholangioscopy was failed. In the operation field, there was a lot of mucin but was no visible mass at the common bile duct with bare eyes and cholangioscopy. However, papilloma was detected at the random biopsy specimen by microscopy. The patient underwent partial resection of common bile duct and choledocho-jejunal anastomosis.
authors.affiliation: Department of Gastrointestinal Medicine, Saint Carollo Hospital, Suncheon, Korea.
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Jeong
authors.forename: Hyeuk
authors.initials: H
authors.lastname: Park
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Moon
authors.forename: Jang Sik
authors.initials: JS
authors.lastname: Mun
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Myoung
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Ho Dong
authors.initials: HD
authors.lastname: Kim
authors.forename: Chul
authors.initials: C
authors.lastname: Han
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D009077:Mucins / Q000378:metabolism*; D010212:Papilloma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D009077:Mucins