case_images: PMC4199794_01
case_images: Radiological images.. Notes: (A and B) Contrast-enhanced abdominal computed tomography revealed dilatation of the intra- and extrahepatic bile duct, including the common bile duct. (C) A computer-reconstructed coronal section image revealed obstruction of the distal common bile duct, which showed abrupt termination on the distal side. (D and E) Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound revealed obstruction of the common bile duct secondary to the intraductal tumor. The arrow indicates the distal end of the common bile duct. The arrowheads indicate the wall of the common bile duct and cystic duct.
case_images: ott-7-1847Fig1.jpg
case_images: PMC4199794_01_ott-7-1847Fig1.jpg
case_images: f1-ott-7-1847
case_images: Abdominal CT revealed dilatation of the intra-and extrahepatic bile duct, including the common bile duct, which showed abrupt termination on the distal side (Figure 1A and B). Computer-reconstructed coronal section images also confirmed the obstruction of the distal common bile duct, and an intraductal tumor in the dilated common bile duct with slightly low attenuation was present on CT (Figure 1C). Endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography also showed obstruction of the common bile duct due to the intraductal tumor (Figure 1D and E).
case_images: Pathological specimens and cholangioscopic images.. Notes: (A and B) Adenocarcinoma cells in a specimen obtained by transbronchial biopsy. (A) x40; (B) x400. (C and D) Adenocarcinoma cells in a specimen obtained from the intraductal tumor. (C) x40. Inset: thyroid transcription factor-1 stain. (D) x400.
case_images: ott-7-1847Fig2.jpg
case_images: PMC4199794_01_ott-7-1847Fig2.jpg
case_images: f2-ott-7-1847
case_images: Adenocarcinoma cells in a specimen obtained by transbronchial biopsy at the time of diagnosis are shown in Figure 2A and B. The biopsy specimen obtained using digestive endoscopy revealed poorly differentiated adenocarcinoma that was positive for thyroid transcription factor-1 by immunohistochemistry (Figure 2C and D).