A Case of Hyperplastic Polyp at Distal Common Bile Duct

Jae Hyuck Chang; In Seok Lee; Eun Sun Jung

doi:10.4166/kjg.2010.55.2.81

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Chang, Lee, and Jung: A Case of Hyperplastic Polyp at Distal Common Bile Duct

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Korean J Gastroenterol 2010;55(2):81-84.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.55.2.81

A Case of Hyperplastic Polyp at Distal Common Bile Duct

Jae Hyuck Chang, M.D., In Seok Lee, M.D., Eun Sun Jung, M.D.^∗

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

^∗Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: In Seok Lee, M.D. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul 137-040, Korea Tel: +82-2-2258-2083, Fax: +82-2-2258-2089 E-mail: isle@catholic.ac.kr

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Fig. 1.

Abdominal CT findings. (A) Contrast enhanced axial image. Focal enhancing polypoid lesion was noted in the ampulla of Vater or distal common bile duct. (B) Coronal image. A polypoid lesion was noted in the ampulla of Vater or distal common bile duct with dilatation of proximal common bile duct.

Fig. 2.

MRI/MRCP and PET CT findings. (A) MRI image. An about 1.4 cm sized bulging contoured lesion was seen at the ampullar portion. This lesion showed enhancement after contrast infusion. (B) MRCP showed diffuse dilatation of the common bile duct and dis-tension of gallbladder with rat-tail appearing abrupt narrowing of the far-distal common bile duct. (C) PET image. Moderate FDG activity was localized in the distal portion of common bile duct.

Fig. 3.

ERCP findings. (A) A large periampullary diverticulum was noted. There was no definite mass at the major ampulla. (B) An 8-mm diameter filling defect was noted at the distal common bile duct.

Fig. 4.

Choledochoscopy showed papillary polyp-like lesion at the distal common bile duct.

Fig. 5.

Pathological findings. (A) Gross examination of the specimen demonstrated a 1.2×1.0 cm polypoid lesion at distal common bile duct adjacent to major ampulla. (B) Papillary lesion was noted by H&E (×40). (C) Diffuse epithelial hyperplasia was seen by H&E (×200).

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