Biliary - Cholangiocarcinoma, Bifurcation, ERCP with DACP, example 1
Comments: This 55 year old lady was recently evaluated for jaundice and her ERCP showed a bifurcation stricture. Her ductal cytology was negative, and she was referred for further evaluation. The DACP scope was advanced through the ampulla and up the bile duct. In the region of the bifurcation, blood is seen oozing from a polypoid, fibrotic, irregular lesion that appears to be originating from the 3 o'clock wall of the bile duct. The adjacent mucosa appears firm and friable. There also appears to be a narrowing or stricturing of the duct in this region. This is the classic choledochoscopic appearance of bile duct bifurcation adenocarcinoma or a Klatskin tumor The area was localized fluoroscopically, and specimens were obtained using both a cytology brush and forceps. Both specimens demonstrated adenocarcinoma, confirming the suspicion of a Klatskin tumor. Palliative stenting was then performed.
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Brenna C. Bounds, M.D. Assistant Professor of Medicine Harvard Medical School Massachusetts General Hospital |
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Citation: Bounds, BC (Dec 04 2003). Biliary - Cholangiocarcinoma, Bifurcation, ERCP with DACP, example 1. The DAVE Project. Retrieved Jul, 30, 2010, from http://daveproject.org/viewfilms.cfm?film_id=22 Times viewed since Feb 2006: 6051 |
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