PMC4286821_01
71-year-old male with obstructive jaundice secondary to CBD lymphoma. (a) Magnetic resonance cholangiopancreatography (MRCP) coronal projection demonstrate 2.3 cm tight stricture at the mid-CBD (white arrows) with severe upstream dilatation. (b and c) Non-contrast MRI upper abdomen axial T1- and T2-weighted images show circumferential mural thickening at the area of maximum stenosis with intermediate signal intensity (black arrows).
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F1
At the area of stricture, there was circumferential mural thickening with intermediate signal intensity in T1- and T2-weighted images and homogeneous post-contrast enhancement [Figures 1 and 2].
71-year-old male with obstructive jaundice secondary to CBD lymphoma. Contrast-enhanced MRI with axial post-contrast T1-weighted images at different levels: (a) at the level of the hepatic duct bifurcation, shows severe bilobar intrahepatic biliary dilatation (short white arrows); (b) at the level of the junction of the markedly dilated proximal CBD (curved white arrow) and the stenotic segment (straight white arrow); (c) at the level of mid-CBD stricture show that the lesion enhances homogeneously (white arrow); (d) at the level of distal CBD shows the normal caliber of the CBD within the pancreatic head (black arrow).
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F2
At the area of stricture, there was circumferential mural thickening with intermediate signal intensity in T1- and T2-weighted images and homogeneous post-contrast enhancement [Figures 1 and 2].
Histological sections stained with hematoxylin and eosin (H and E) (a) low-power view, (x25) shows nodules of lymphoid cells (white arrows) surrounding the common bile duct (dotted white arrows). (b) medium-power view, (x200) shows the nodules with a mix of neoplastic centrocytes and centroblasts. Immunochemical tests (c) shows the neoplastic lymphoid cells are positive for CD20 marker and (d) the cells are positive for CD10 marker.
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F3
The centroblasts counted more than 16 cells per high-power field [Figure 3a and b]. Immunohistochemical staining showed the neoplastic cells were positive for cluster of differentiation 20 (CD20), cluster of differentiation 10 (CD10), and B cell lymphoma 6 (BCL6) markers [Figure 3c and d].