Lymphoma in the wall of the bile ducts: Radiologic imaging

Vm, Tartar; Balfe, D M

doi:10.1007/bf01888735

Cited by 32 publications

(11 citation statements)

References 5 publications

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“…Obstruction of the extrahepatic bile duct by lymphoma can take various forms, including primary NHL arising from the extrahepatic bile duct [7,[23][24][25][26], primary involvement of the CBD by HD [8], compression of the extrahepatic bile duct by enlarged lymph nodes [1, 3-6, 14, 22], primary lymphoma arising from the porta hepatis [9,27,28], primary lymphoma of the ampulla of Vater [10], primary lymphoma of the pancreas involving the CBD by direct extension [11], gastrointestinal lymphoma obstructing the bile duct at the ampulla of Vater [12,16,29], and radiation-induced biliary stricture [13].…”

Section: Discussionmentioning

confidence: 99%

Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

et al. 2007

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Lymphoma is a rare cause of biliary obstruction and, on cholangiography, may mimic other causes of obstructive jaundice. The optimum treatment for these patients is unclear. The aim of this study is to evaluate the incidence, clinical and imaging findings, management, and outcome of biliary obstruction caused by lymphoma. Our database was searched retrospectively for patients with biliary obstruction due to lymphoma between 1999 and 2005. Biliary obstruction secondary to lymphoma was found in 7 (0.6%) of 1123 patients with malignant biliary obstruction. One patient had benign biliary obstruction related to lymphoma. Of the eight patients (five male, three female; mean age, 34.50 +/- 17.93 years), four had Hodgkin's disease and four had non-Hodgkin's lymphoma. Biliary obstruction occurred as part of the initial or early presentation of lymphoma in two patients. The most common cause of obstruction was compression of the biliary tract by enlarged lymph nodes (six patients). Cholangiographic appearances were diverse: narrowing of the common bile duct (six patients), splayed and narrowed common bile duct (one patient), and multiple strictures and dilatations of the intrahepatic bile ducts (one patient). Biliary drainage was performed in all patients including endoscopic stent placement in six patients, nasobiliary drainage in one, and choledochoduodenostomy in one. Hyperbilirubinemia resolved in all but one of the patients with a stent; however, none could be maintained in a stent-free condition. Five patients died within 1 year after onset of jaundice. One of the surviving patients developed a late benign stricture at the site of the earlier lymphoma. We conclude that lymphoma should be considered in the differential diagnosis of obstructive jaundice, particularly in younger patients. We suggest that biliary drainage by the endoscopic or percutaneous route is necessary for the treatment of these patients. Late benign strictures may develop. Biliary obstruction is a sign of poor prognosis in lymphoma.

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Section: Discussionmentioning

confidence: 99%

Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

et al. 2007

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“…17,22 Twelve patients (including ours) were treated by surgery and chemotherapy and/or radiotherapy. [7][8][9][10][11][12][13][14]16,17,22 Five patients were treated by only surgery. 15,18,19,21,23 Only one patient was treated by chemotherapy without surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, 16 cases of primary non-Hodgkin's lymphomas arising from the extrahepatic bile duct have been documented in the literature. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] We, herein, report an additional case of obstructive jaundice caused by primary non-Hodgkin's lymphoma of the common bile duct, in a 21-year-old woman. We also review the literature pertaining to this condition.…”

Section: Introductionmentioning

confidence: 99%

Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice

et al. 2004

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Primary non-Hodgkin's lymphoma of the extrahepatic bile duct presenting as obstructive jaundice is an extremely rare disease. At this writing, a review of the medical literature disclosed 17 reported cases of primary non-Hodgkin's lymphoma arising from the extrahepatic bile duct. We, herein, report an additional case of obstructive jaundice caused by primary non-Hodgkin's lymphoma of the common bile duct, in a 21-year-old woman. Our patient showed clinical evidence of obstructive jaundice, and endoscopic retrograde cholangiopancreatography and abdominal magnetic resonance imaging demonstrated a long strictured segment of the common bile duct with proximal bile duct dilatation. These clinical and radiological findings resembled those of cholangiocarcinoma. Resection of the common bile duct tumor, cholecystectomy, lymph node dissection, and Roux-en-Y hepaticojejunostomy were carried out. Histology and immunohistochemistry of the resected specimen confirmed a diffuse large B-cell-type malignant lymphoma involving the common bile duct. She received four courses of combination chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and 3060 cGy external irradiation. She has been well, without evidence of tumor recurrence, 17 months after the surgery. In summary, first, primary non-Hodgkin's lymphoma of the extrahepatic bile duct, despite its rarity, should be considered in the differential diagnosis of causes of obstructive jaundice. Second, an accurate histopathologic diagnosis and surgical resection, if feasible, combined with chemotherapy with or without radiotherapy may be the approach to offer a chance for cure.

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“…A patient reported by Neal et al (3) had diffuse gallbladder wall thickening on ultrasound. In the other two patients, ultrasonographic features of the gallbladder involvement were not reported (4,5).…”

Section: Ultrasonographic Features Of a Large B-cell Lymphoma Of The mentioning

confidence: 91%

Ultrasonographic features of a large B-cell lymphoma of the gallbladder

Sezgın¹,

Altıntaş²,

Polat³

et al. 2009

Turk J Gastroenterol

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Lymphoma of the gallbladder is very rare (1, 2). There is no adequate knowledge of the findings on ultrasonography, which is the first-step gold standard assessment tool of the gallbladder pathology. The aim of this letter was to describe the ultrasonographic findings of lymphoma involvement of the gallbladder.A 32-year-old female patient was admitted to our hospital with abdominal pain, bloody diarrhea and weight loss. Renal transplantation had been performed eight years before. Various immunosuppressive drugs had been used. Abdominal ultrasonography demonstrated a diffusely thickened, hypoechoic gallbladder wall (31 mm), but the echogenic inner layer of the wall was preserved with no evidence of gallstones (Figure 1a, b). Thicknesses of the duodenum and right colonic wall were also determined. Upper gastrointestinal endoscopy revealed a fragile, ulcerated mass in the duodenal bulb. Biopsy specimen from the mass revealed diffuse involvement by a lymphocytic proliferative process with a diffuse cell type of B-cell lineage. The patient was diagnosed with intestinal non-Hodgkin lymphoma and gallbladder involvement. Five days after the initiation of chemotherapy, endoscopically treated bleeding from the duodenal mass and then intestinal perforation occurred. Abdominal ultrasonography demonstrated considerable decrease in the gallbladder wall (to 15 mm) and intestinal wall thickening (Figure 2a, b). In urgent laparotomy, small bowel perforation was observed, and partial resection of the small bowel, distal gastrectomy, cholecystectomy, and appendectomy were carried out. On histological examination, diffuse large B cell lymphoma of the gallbladder, appendix and small bowel were con-

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Lymphoma in the wall of the bile ducts: Radiologic imaging

Cited by 32 publications

References 5 publications

Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice

Ultrasonographic features of a large B-cell lymphoma of the gallbladder

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