PMC9121450_01
CT axial plane (A) and coronal plane (B) showing dilated gallbladder and
extrahepatic biliary system indicated by arrow heads.
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The pancreatic duct was not dilated (Figure 1).
(A) Macroscopic view of the mucosal bulge at the ampulla of Vater and (B) cut
sections through the pancreatic head reveal an irregular white tumour
arising from common bile duct (arrowhead).
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Cut sections through the pancreatic head revealed a 16 x 12 x 10 mm irregular, firm, white tumour just beneath the duodenal mucosa arising from the common bile duct close to the junction with the main pancreatic duct (Figure 2).
Microscopic view of AC and SCC junction ((A) - H&E section x100
magnification; (B) - H&E section x200 magnification), (C)
immunohistochemistry showing co-expression of CK7 in the AC component (x40
magnification), (D) immunohistochemistry showing co-expression of CK5/6 in
the SCC component (x100 magnification).
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The tumour showed co-expression of CK7 and CK 5/6 (Figure 3).