PMC5933476_01
Computed tomography scan with the yellow arrow pointing at the tumor.
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A computed tomography scan revealed a tumor in the pancreatic head without invasion into the surrounding organs (Fig. 1).
Resection specimen with the yellow arrow pointing to the tumor in the common bile duct.
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The surgical specimen revealed a tumor arising in the common bile duct with pancreatic involvement, and possible extension to the duodenum and into surrounding fat tissue (Fig. 2).
Poorly differentiated carcinoma of the common bile duct on hematoxylin and eosin stain x 400.
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EBV positivity in the tumor cells (Fig. 3: hematoxylin and eosin stain x 400 and Fig. 4: EBV-encoded RNA stain x 400). Eighteen specimen lymph nodes were identified and four lymph nodes revealed carcinoma metastases with histopathological features of the primary.