case_images: PMC11151743_01
case_images: Imaging data of the patient. Ultrasonography showed several hyperechoic masses within the dilated bile duct (A). Computed tomography showed some slightly high-density masses in the bile duct (B). Magnetic resonance cholangiopancreatography showed some hypointense masses within the dilated bile duct (C). Endoscopic retrograde cholangiopancreatography showed a filling defect at the middle bile duct after several stones were removed (D). Lesion locations are marked with arrows.
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case_images: Several hyperechoic masses with a diameter of 0.4-0.8 cm were observed in the bile duct, which exhibited apparent acoustic shadows ( Figure 1A ). Computed tomography (CT) also revealed multiple slightly high-density masses within the dilated bile duct ( Figure 1B ). Magnetic resonance cholangiopancreatography (MRCP) demonstrated hypointense masses in the bile duct ( Figure 1C ). Figure 1D ). Five days after the stones were removed by ERCP, the patient underwent peroral choledochoscopy.
case_images: Choledochoscopic findings of intraductal oncocytic papillary neoplasm of the bile duct. Choledochoscopy showed many papillary protuberances (A) surrounded by fish-egg-like mucosa (B).
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case_images: Peroral choledochoscopy (SpyGlass DS II, Boston Scientific Corporation, Delaware, United States) showed that the mass appeared as many papillary protuberances surrounded by fish-egg-like mucosa ( Figure 2 ).
case_images: Histological features of the neoplasm ((A): HE, x200; (B): HE, x400). The neoplasm showed papillary structures with fibrovascular cores. Neoplasm cells contained a large amount of eosinophilic cytoplasm and round nuclei.
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case_images: Figure 3 ). Finally, no distant metastasis or involvement of regional lymph nodes was apparent.