Korean J Radiol.  2013 Oct;14(5):764-768. 10.3348/kjr.2013.14.5.764.

Primary Malt Lymphoma of the Common Bile Duct

• Cho YH
• Byun JH
• Kim JH
• Lee SS
• Kim HJ
• Lee MG

• KMID: 1711430
• DOI: http://doi.org/10.3348/kjr.2013.14.5.764

Abstract

Primary mucosa-associated lymphoid tissue (MALT) lymphoma arising in the common bile duct (CBD) is extremely rare. In our case of MALT lymphoma, CT and MRI showed long, segmental, irregular wall thickening of the CBD and minimal dilatation of the upstream bile duct. A preoperative diagnosis of cholangiocarcinoma was made, but histologic evaluation confirmed MALT lymphoma of the CBD. We herein present a rare case of MALT lymphoma of the CBD with CT and MRI findings.

Keyword

Mucosa-associated lymphoid tissue lymphomas; Common bile duct; CT; MRI

MeSH Terms

Aged
Bile Duct Neoplasms/*diagnosis/surgery
*Common Bile Duct
Diagnosis, Differential
Humans
Lymphoma, B-Cell, Marginal Zone/*diagnosis/surgery
Magnetic Resonance Imaging
Male
Pancreaticoduodenectomy
Preoperative Period
Tomography, X-Ray Computed/*methods

Figure

• 

  Fig. 1 Seventy nine-year-old male patient with abdominal pain and progressive jaundice. A. CT scan of abdomen during arterial phase reveals concentric wall thickening of common bile duct (CBD; arrow) with similar degree of enhancement compared to hepatic parenchyma. B. Coronal reconstructed CT image during portal phase shows long segmental, irregular wall thickening (open arrows) of CBD. C. Diffusion-weighted MR imaging (b-value of 800) demonstrates heterogeneous high signal intensity (arrow) of thickened wall of CBD. D. MR cholangiopancreatography using single-shot rapid acquisition with relaxation enhancement sequence (TR/TE, infinite/1000; echo train length, 256; FOV, 250 × 250; slice thickness, 40 mm) shows irregular luminal narrowing of entire CBD (open arrows) and mild dilatation of common hepatic duct and intrahepatic duct. Incidental pancreatic divisum is also noted. TR = time to repetition, TE = echo time, FOV = field of view. E. Endoscopic retrograde cholangiopancreatography reveals diffuse narrowing and irregularity of CBD lumen with mild dilatation of upstream intrahepatic bile ducts. Small, saccular out-pouching lesion (arrow) is also noted in proximal CBD. F. Photography for gross specimen reveals diffuse thickening of CBD wall (arrow heads). G. Histologic examination under light microscopy reveals dense and diffuse infiltration of atypical lymphoid cells within CBD walls as well as formation of lymphoid follicles (H and E staining, × 200). CBD = common bile duct

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