Primary diffuse large B cell lymphoma of the common bile duct causing obstructive jaundice

Hiroaki Kato1, Masanori Tsujie1, Tomoko Wakasa2, Shuhei Kogata1, Hirofumi Kanaizumi1, Hiroshi Takeyama1, Johji Hara1, Kotaro Kitani1, Yoshinori Fujiwara1, Shigeto Mizuno3, Toshihiko Kawasaki3, Yoshio Ohta2, Masao Yukawa1, Masatoshi Inoue1
1Department of Surgery, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan
2Department of Pathology and Laboratory Medicine, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan
3Department of Gastroenterology and Hepatology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan

Tóm tắt

We report a rare case of a diffuse large B-cell lymphoma (DLBCL) arising from the common bile duct (CBD). A 77-year old man presented with general fatigue and obstructive jaundice. Abdominal computed tomography revealed a well-circumscribed enhancing mass in the midportion of the CBD with proximal bile duct dilatation. Endoscopic retrograde cholangiopancreatography (ERCP) also showed a midportion of the CBD stricture. Direct peroral cholangioscopy revealed smooth mass in the midportion of the CBD, and narrow-band imaging (NBI) showed irregular tortuous microvessels. The brushing cytology of the CBD was performed, and it was diagnosed as suspicious for poorly differentiated adenocarcinoma or malignant lymphoma. We performed extrahepatic bile duct resection for accurate diagnosis. Histological and immunohistochemical examination of the resected specimen revealed DLBCL. Although systemic chemotherapy is the mainstay of treatment for DLBCL, he refused scheduled subsequent chemotherapy, and died of multiple liver metastases 6 months after surgery.

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Tài liệu tham khảo

Poggi MM, Cong PJ, Coleman CN et al (2002) Low-grade follicular lymphoma of the small intestine. J Clin Gastroenterol 34:155–159

Nguyen GK (1982) Primary extranodal non-Hodgkin’s lymphoma of the extrahepatic bile ducts. Report of a case. Cancer 50:2218–2222

Takehara T, Matsuda H, Naitou M et al (1989) A case report of primary extranodal non-Hodgkin’s lymphoma of the extrahepatic bile duct. Acta Hepatol Jpn 88:247–252

Kaplan LD, Kahn J, Jacobson M et al (1989) Primary bile duct lymphoma in the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 110:161–162

Tartar VM, Balfe DM (1990) Lymphoma in the wall of the bile ducts: radiologic imaging. Gastrointest Radiol 15:53–57

Tzanakakis GN, Vezeridis MP, Jackson BT et al (1990) Primary extranodal non-Hodgkin’s lymphoma of the extrahepatic biliary tract. RI Med J 73:483–486

Kosuge T, Makuuchi M, Ozaki H et al (1991) Primary lymphoma of the common bile duct. Hepatogastroenterology 38:235–238

Brouland JP, Molimard J, Nemeth J et al (1993) Primary T cell rich B cell lymphoma of the common bile duct. Virchows Arch A Pathol Anat Histopathol 423:513–517

Machado MC, Abdo EE, Penteado S et al (1994) Lymphoma of the biliary tract: report of two cases. Rev Hosp Clin Fac Med Sao Paolo 49:64–68

Chiu KW, Changchien CS, Chen L et al (1995) Primary malignant lymphoma of common bile duct presenting as acute obstructive jaundice: report of a case. J Clin Gastroenterol 20:259–261

Andre SB, Farias AQ, Bittencourt PL et al (1996) Primary extranodal non-Hodgkin’s lymphoma of the extrahepatic bile duct mimicking Klatskin tumor. Rev Hosp Clin Fac Med Sao Paolo 51:192–194

Maymind M, Mergelas JE, Seibert DG et al (1997) Primary non- Hodgkin’s lymphoma of the common bile duct. Am J Gastroenterol 92:1543–1546

Podbielski FJ, Pearsall GF Jr, Nelson DG et al (1997) Lymphoma of the extrahepatic biliary ducts in acquired immunodeficiency syndrome. Am Surg 63:807–810

Oda I, Inui N, Onodera Y et al (1999) An autopsy case of primary non-Hodgkin’s lymphoma of the extrahepatic bile duct. Nippon Shokakibyo Gakkai Zasshi (Japanese Journal of Gastroenterology) 96:418–422

Corbinais S, Caulet-Maugendre S, Pagenault M et al (2000) Primary T cell lymphoma of the common bile duct. Gastroenterol Clin Biol 24:843–847

Eliason SC, Grosso LE (2001) Primary biliary lymphoma clinically mimicking cholangiocarcinoma: a case report and review of the literature. Ann Diagn Pathol 5:25–33

Gravel J, Lallier M, Garel L et al (2001) Primary non-Hodgkin lymphoma of the extrahepatic biliary tract and gallbladder in a child. J Pediatr Gastroenterol Nutr 32:598–601

Kang CS, Lee YS, Kim SM et al (2001) Low-grade B cell lymphoma of mucosa-associated lymphoid tissue type of the common bile duct. J Gastroenterol Hepatol 16:949–951

Das K, Fisher A, Wilson DJ et al (2003) Primary non-Hodgkin’s lymphoma of the bile ducts mimicking cholangiocarcinoma. Surgery 134:496–500

Ferluga D, Luzar B, Gadzijev E (2003) Follicular lymphoma of the gallbladder and extrahepatic bile ducts. Virchows Arch 442:136–140

Suzuki S, Tanaka S, Suzuki M et al (2004) Mucosa-associated lymphoid tissue-type lymphoproliferative lesion of the common bile duct. Hepatogastroenterology 51:110–113

Joo YE, Park CH, Lee WS (2004) Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice. J Gastroenterol 39:692–696

Sugawara G, Nagino M, Oda K et al (2008) Follicular Lymphoma of the extrahepatic bile duct mimicking cholangiocarcinoma. J Hepatobiliary Pancreat Surg 15:196–199

Shito M, Kakefuda T, Omori T et al (2008) Primary non-Hodgkin’s lymphoma of the main hepatic duct junction. J Hepatobiliary Pancreat Surg 15:440–443

Dote H, Ohta K, Nishimura R et al (2009) Primary extranodal non-Hodgkin’s lymphoma of the common bile duct manifesting as obstructive jaundice: report of a case. Surg Today 39:448–451

Christophides T, Samstein B, Emond J et al (2009) Primary follicular lymphoma of the extrahepatic bile duct mimicking a hilar cholangiocarcinoma: a case report and review of the literature. Hum Pathol 30:1808–1812

Kang HG, Choi JS, Seo JA et al (2009) A case of primary biliary malignant lymphoma mimicking Klatskin tumor. Korean J Gastroenterol 54:191–195

Yoon MA, Lee JM, Kim SH et al (2009) Primary biliary lymphoma mimicking cholangiocarcinoma: a characteristic feature of discrepant CT and direct cholangiography findings. J Korean Med Sci 24:956–959

Luigiano C, Ferrara F, Fabbri C et al (2010) Primary lymphoma of the common bile duct presenting with acute pancreatitis and cholangitis. Endoscopy 42:265–266

Khozeimeh N, Bhatti T, Ponsky TA et al (2012) Primary non-Hodgkin’s lymphoma of the extrahepatic bile duct. J Gastrointest Cancer 43:46–49

Zakaria A, Al-Obeidi S, Daradkeh S (2013) Primary non-Hodgkin’s lymphoma of the common bile duct: a case report and literature review. Asian J Surg. doi:10.1016/j.asjsur.2013.09.009

Hans CP, Weisenburger DD, Greiner TC et al (2004) Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood 103:275–282

Lokich JJ, Kane RA, Harrison DA et al (1987) Biliary tract obstruction secondary to cancer: management guidelines and selected literature review. J Clin Oncol 5:969–981

Coiffier B (2005) State-of-the-art therapeutics: diffuse large B cell lymphoma. J Clin Oncol 10;23(26):6387–93