PMC4748200_01
MRCP showing partially obstructing polypoid lesion in proximal extrahepatic bile duct (arrow).
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F1
Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) verified a partially obstructing polypoid lesion (2 x 0.6 cm) in the common hepatic duct (CHD; Figure 1).
ERCP revealing a 15-mm irregular fixed filling defect in common hepatic duct just proximal to the cystic duct (arrow).
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F2
An endoscopic retrograde cholangiopancreatography (ERCP) with SpyGlass  cholangioscopy (Boston Scientific, Natick, MA) identified a 1.5-cm friable, irregular polypoid lesion in the CHD, which was sampled with CHD brushings and SpyBite  forceps biopsy (Boston Scientific, Natick, MA; Figure 2).
Photomicrographs showing a proliferation of tumor cells within the bile duct mucosa and submucosa. The cells have eosinophilic and granular cytoplasm, with no significant cytologic atypia. No mitosis is identified. H&E stain at (A) x20 magnification and (B) x200 magnification.
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F3
Complete surgical excision with cholecystectomy and hepaticojejunostomy was performed followed by histopathological examination, confirming the diagnosis of GCT of the CBD/CHD (Figure 3).
Photomicrograph showing tumor cells that are diffusely and strongly positive for S-100 on immunohistochemical stain (x100 magnification).
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F4
Immunohistochemical staining of tumor cells was S-100 positive and neurofilament, smooth muscle actin and c-kit negative (Figure 4).