PMC9894337_01
Endoscopic ultrasound showing an enlarged lymph node (arrows).
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F1
Endoscopic ultrasound (EUS) revealed intrahepatic biliary duct dilation and multiple enlarged lymph nodes in the porta hepatis region with the largest measured 28 x 26 mm in diameter (Figure 1).
Endoscopic retrograde cholangiopancreatography showing a single severe stricture involving the common hepatic duct (arrow).
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F2
Endoscopic retrograde cholangiopancreatography (ERCP) was performed and revealed a single severe stricture involving the common hepatic duct 20 mm in length (Figure 2).
Cholangioscopy showing abnormal mucosa characterized by irregularity and nodularity without significant neovascularization.
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F3
A single-operator cholangioscopy was then performed, and abnormal mucosa characterized by irregularity and nodularity without significant neovascularization was found in the region of the common hepatic duct (Figure 3).
Pathology slide showing reactive ductal epithelial cells with chronic inflammation and noncaseating granulomas (black arrows).
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F4
Cholangioscopy-directed biopsies were obtained, and the pathology results showed reactive ductal epithelial cells with chronic inflammation and noncaseating granulomas (Figure 4).