Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2020 Nov 9;13(11):e237001. doi: 10.1136/bcr-2020-237001.
A 45-year-old woman was referred from Department of Dermatology to Surgery outpatient department with pruritus since 6 months and an episode of jaundice that lasted for 15 days about 6 months ago. She was referred with a contrast-enhanced MRI finding that showed a small lesion in the lower end of common bile duct. Endoscopy-guided biopsy was performed twice at our hospital, the second revealed low grade dysplasia. Consequently, she underwent pancreaticoduodenectomy. Intraoperatively, there were both vascular and biliary anatomical variations that were missed on preoperative images. On histopathological examination, it turned out to be a mixed variety of intraductal papillary neoplasm of bile duct (IPNB). As all findings were rare in one, hence, we present this case of IPNB that presented to us with variable clinical, radiological, surgical and pathological findings.
一位 45 岁女性因瘙痒 6 个月和 6 个月前持续 15 天的黄疸发作，从皮肤科转至外科门诊。增强磁共振成像显示胆总管下段有一个小病灶，因此她被转来我院。内镜引导下活检在我院进行了两次，第二次提示低级别异型增生。随后，她接受了胰十二指肠切除术。术中发现术前图像漏诊了血管和胆道解剖变异。组织病理学检查结果显示为胆管内乳头状肿瘤（IPNB）的混合类型。由于所有表现都很少见，因此我们报告了这例以不同临床表现、影像学、手术和病理学表现为主的 IPNB。
