PMC4706539_01
Arterial phase CT scan of a 54-year-old woman shows a high-density stent in the bile duct and a hypodense tumoral lesion in the periampullary region
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Fig1
Computer tomography (CT) scan revealed a mass with a size of 13 mm in the ampullary region consistent with periampullary tumor (Fig. 1).
Contrast-enhanced T1-weighted MRI shows a hypointense lesion in the periampullary region near normal hyperintense pancreatic tissue
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Fig2
T2-weighted MRI shows the hypointense tumoral lesion in the periampullary region which has a crescent-like shape
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Fig3
MIP image of the MRCP shows significant dilatation of the intrahepatic and proximal extrahepatic bile ducts with maximum dimension of 14 mm. Note that the tumoral lesion extends to the distal part of extrahepatic bile duct
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Fig4
In axial PET image, FDG 18 (fluorodeoxy-glucose) uptake is seen in the periampullary region
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Fig5
Positron emission tomography (PET CT) revealed FDG (fluorodeoxy-glucose) uptake only in the periampullary region of the pancreas (Fig. 5).
a Tumor location in the common bile duct. b Tumor invasion to the duodenum (on the left) and to the pancreas (on the right)
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Fig6
Tumor invasion to the common bile duct
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Fig7
Photomicrographs of the resected specimen are shown in Figs. 7, 8, 9, and 10.
The presence of keratin pearls within the islets of atypical squamous cells
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Fig8
Photomicrographs of the resected specimen are shown in Figs. 7, 8, 9, and 10.
a Tumor invasion to the muscular layer of the duodenum and b to the pancreas
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Fig9
Photomicrographs of the resected specimen are shown in Figs. 7, 8, 9, and 10.
a Positive staining with p63 and b HMWCK
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Fig10
Photomicrographs of the resected specimen are shown in Figs. 7, 8, 9, and 10.