case_images: PMC11249448_01
case_images: a, b Contrast-enhanced computed tomography showed localized wall thickening in the middle bile duct, and the upstream bile ducts were slightly dilated. In addition, there was continuous thickening of the bile duct wall from the gallbladder to the confluence of the cystic duct. No distant metastasis, such as liver metastasis or nearby enlarged lymph nodes, was observed.
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case_images: F1
case_images: No distant metastases, such as liver metastases, or nearby enlarged lymph nodes were observed (Fig. 1).
case_images: a, b Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed that a papillary-like elevated lesion in the bile duct around the confluence of the cystic duct. A subsequent biliary biopsy and biliary brushing from the same area showed no malignant findings.
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case_images: F2
case_images: Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed a papillary-like elevated lesion in the bile duct around the confluence of the cystic duct (Fig. 2).
case_images: Endoscopic ultrasonography showed irregular thickening of the gallbladder wall and a tumor contiguous from the gallbladder to the cystic duct.
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case_images: F3
case_images: Endoscopic ultrasonography showed irregular thickening of the gallbladder wall and a contiguous tumor from the gallbladder to the cystic duct (Fig. 3).
case_images: A gross examination of the resected specimen revealed severe atrophy of the gallbladder and polypoid lesions in the bile ducts.
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case_images: F4
case_images: A gross examination of the resected specimen revealed severe atrophy of the gallbladder and polypoid lesions in the bile duct (Fig. 4).
case_images: a, b A histopathological examination of the resected specimen revealed that hyperplasia of the accessory glands of the bile ducts, with proliferation of the small glandular ducts within the polypoid lesion, which retained a lobular structure with little atypia.
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case_images: F5
case_images: A histopathological examination of the resected specimen revealed hyperplasia of the accessory glands in the bile ducts from the cystic duct to the confluence of the cystic duct, with proliferation of the small glandular ducts within the polypoid lesion, which retained the lobular structure without dysplasia (Fig. 5).