EDITOR'S QUIZ: GI SNAPSHOT

Unusual findings in the biliary tract

N Ueno¹, Y Kawaguchi², I Kawana², S Umemura²

¹ Division of Endoscopy, Yokohama City University Hospital, Yokohama, Japan
² Second Department of Internal Medicine, Yokohama City University, School of Medicine, Yokohama, Japan

Correspondence to:
Correspondence to:
Dr N Ueno
Division of Endoscopy, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; nu-1952@io.ocn.ne.jp

Keywords: cholangiocellular carcinoma; mucin; intraductal tumour

The first 150 words of the full text of this article appear below.

A 65 year old woman consulted a local clinic because of elevated liver enzymes recognised on annual routine check. Dilation of the bile duct along with a cystic mass in the left lobe of the liver was then demonstrated on ultrasound. She was referred to our hospital for further evaluation. Laboratory examination demonstrated mild elevation of biliary tract enzymes (glutamate-oxaloacetate transaminase 36 IU/l (normal range 14–32); glutamic pyruvic transaminase 20 IU/l (normal range 9–25); alkaline phosphatase 315 IU/l (normal range 109–312); -glutamyl transpeptidase 169 IU/l (normal range 10–28); and total bilirubin 1.0 mg/dl (normal range 0.2–1.2)). Levels of tumour markers were within normal limits (-fetoprotein 6 (normal range 1–7); carcinoembryonic antigen 3.2 ng/ml (normal range 0.6–3.8); cancer antigen 19–9 U/ml (normal range 1–37)). Endoscopic retrograde cholangiography showed filling defects at the upper part of the extrahepatic bile duct, and opacification of the left hepatic bile duct was insufficient (fig . . . [Full text of this article]

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