J Korean Med Sci.  2007 Jun;22(3):549-552. 10.3346/jkms.2007.22.3.549.

Extrahepatic Biliary Schwannomas: A Case Report

• Jung JH
• Joo KR
• Chae MJ
• Jang JY
• Lee SG
• Dong SH
• Kim HJ
• Kim BH
• Chang YW
• Lee JI
• Chang R
• Kim YH
• Lee SM

• KMID: 1778369
• DOI: http://doi.org/10.3346/jkms.2007.22.3.549

Abstract

Benign schwannomas arise in neural crest-derived Schwann cells. They can occur almost anywhere in the body, but their most common locations are the central nervous system, extremities, neck, mediastinum, and retroperitoneum. Schwannomas occurring in the biliary tract are extremely rare and mostly present with obstructive jaundice. We recently experienced a case of extrahepatic biliary schwannomas in a 64-yr-old female patient who presented with intra- and extrahepatic bile duct and gallbladder stones during a screening program. To the best of our knowledge, extrahepatic biliary schwannomas associated with bile duct stones have not been reported previously in the literature.

Keyword

Schwannomas; Bile Duct, Extrahepatic; Calculi, Bile Duct

MeSH Terms

Adult
Bile Ducts/pathology
Bile Ducts, Extrahepatic/*metabolism/*pathology
Central Nervous System/pathology
Cholangiography/methods
Endoscopy
Female
Humans
Male
Middle Aged
Neurilemmoma/*diagnosis/*pathology
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Computed tomographic scan shows mildly dilated intrahepatic bile duct and many small stones in the gallbladder.

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  Fig. 2 Endoscopic retrograde cholangiography shows a focal stricture of the proximal common bile duct and an upstream bile duct dilatation with stones. The cystic duct is inserted aberrantly into the right intrahepatic duct. Gallbladder stones are also observed.

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  Fig. 3 (A) The specimen shows several well-demarcated nodules in the bile duct wall. (B) A nodule shows a typical pattern of a schwannoma consisting of spindle cells. Lymphocyte cuffing is also seen in the margin of the tumor (H&E ×100). (C) Magnified view shows interlacing fascicles with nuclear palisading (H&E ×200). (D) Immunochemical staining is positive for the S-100 protein (×100).

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