PMC7677652_01
Magnetic resonance cholangiopancreatography images of common bile duct (CBD). Dilated proximal CBD measuring 12 millimetr is evident. The arrow shows filling defect in mid CBD.
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ERCP, we consulted with gastroentrologists at our center and they proposed performing Magnetic Resonance Cholangiopancreatography (MRCP) and it revealed a filling defect at the mid CBD with proximal of the CBD being dilated to 12 mm (Fig. 1). ERCP reported mid CBD stenosis or impacted stone which was bypassed via an 8 cm 10f plastic stent and bile drainage was achieved.
Computed Tomography scan images of the common bile duct.. Histologic features of well differentiated neuroendocrine tumor of CBD: A, B: Bile duct wall is infiltrated by tumor (H&E, 100x, 100x). C: Tumor cells show mild cytologic atypia, round to oval nuclei, stippled chromatin and eosinphilic to clear cytoplasm (H&E, 400x).. Immunohistochemical study of well differentiated neuroendocrine tumor of CBD: D,E: Immunohistochemical staining with Synaptophysin and Chromogranin is diffusely positive (IHC, 400x, 400x). F: KI-67 is positive in about 8 percent of tumoral nuclei (IHC, 100x).
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The pathology report indicated that CBD lesion was well-differentiated neuroendocrine tumor grade II with perineural and lympho-vascular invasion (Fig. 2).