International Journal of Hematology

DOI: 10.1007/s12185-019-02661-7 Pages: 381-384

Significance of biopsy with ERCP for diagnosis of bile duct invasion of DLBCL

1. The University of Tokyo, Department of Hematology and Oncology, Graduate School of Medicine

2. The University of Tokyo, Department of Gastroenterology

3. The University of Tokyo, Department of Pathology, Graduate School of Medicine

4. The University of Tokyo Hospital, Department of Cell Therapy and Transplantation Medicine

Correspondence to:
Mineo Kurokawa
Tel: +81-3-5800-9045
Email: kurokawa-tky@umin.ac.jp

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Abstract

Obstructive jaundice is an initial symptom in 1–2% of diffuse large B cell lymphoma (DLBCL) cases. The major cause of bile duct obstruction in patients with DLBCL is extrinsic compression by enlarged lymph nodes. In such cases, the existence of bile duct invasion of lymphoma is rarely mentioned or observed pathologically, so the ratio of bile duct invasion to the total cases of obstructive jaundice, and its significance remains unknown. We report two cases of DLBCL presenting as an obstructive jaundice, in which we demonstrated bile duct invasion pathologically by biopsy from the wall of common bile duct with endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic stent placement is a minimally invasive procedure to relieve cholestasis and is effective for diagnosing bile duct invasion. This procedure should thus be performed in all cases of obstructive jaundice caused by lymphoma to evaluate for bile duct invasion. Our cases suggest that ERCP may be useful as a diagnostic procedure for bile duct invasion.

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