PMC3014831_01
ERCP showing irregular wall contours, variable intrahepatic stenoses, and two distal common bile duct stones.
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fig1
Then endoscopic retrograde cholangiopancreatography (ERCP) was performed and found multiple irregularities over bilateral intrahepatic bile ducts: common bile duct was not dilated but with two small stones distally (Figure 1).
Marked expansion of portal tracts by fibrosis and inflammation (low-power view).
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fig2
These were consistent with primary sclerosing cholangitis, Stage III (Ludwig) (Figures 2, 3 and 4).
Concentric fibrosis and portal tract inflammation (intermediate-power view).
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fig3
These were consistent with primary sclerosing cholangitis, Stage III (Ludwig) (Figures 2, 3 and 4).
Atrophic interlobular bile duct (high-power view).
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fig4
These were consistent with primary sclerosing cholangitis, Stage III (Ludwig) (Figures 2, 3 and 4).