Primary Bile Duct Diffuse Large B-cell Lymphoma Diagnosed by Repeated Endoscopic Ultrasound-guided Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography

Intern Med. 2024 Feb 15;63(4):493-501. doi: 10.2169/internalmedicine.1776-23. Epub 2023 Jun 21.

Abstract

A 54-year-old man was admitted with obstructive jaundice. Computed tomography showed common bile duct stricture and a tumor around the celiac artery. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) as well as a laparotomic biopsy around the celiac artery were diagnostically unsuccessful. Since the bile duct stricture progressed, EUS-FNA and ERCP were performed a third time, finally leading to the diagnosis of diffuse large B-cell lymphoma. The treatment plan and prognosis of obstructive jaundice differ greatly depending on the disease. It is important to conduct careful follow-up and repeated histological examinations with appropriate modifications until a diagnosis is made.

Keywords: ERCP; EUS-FNA; bile duct; diffuse large B-cell lymphoma; obstructive jaundice.

Publication types

  • Case Reports

MeSH terms

  • Bile Ducts / pathology
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Cholestasis*
  • Constriction, Pathologic
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Humans
  • Jaundice, Obstructive* / etiology
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Male
  • Middle Aged
  • Pancreatic Neoplasms* / pathology