Eosinophilic cholangitis with obstructive jaundice mimicking bile duct carcinoma

Chen, Wei‐Hsin; Yu, Cheng-Chan; Wu, Chien-Hung; Jan, Yee-Jee

doi:10.1007/s00534-008-0041-y

Cited by 16 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Some other diseases, e.g., eosinophilic cholangitis, 9,10 eosinophilic cholangiopathy, 11 sclerosing cholangitis, 12 eosinophilic cholecystitis, 9,13 and eosinophilic pancreatitis, 14 also showed marked eosinophilic infi ltration, some of these associated with peripheral eosinophilia 12,14 and stenosis of the bile duct. [9][10][11][12] However, cases similar to those presented in this study have not been described in the literature.…”

Section: Discussioncontrasting

confidence: 37%

“…This clumping could induce complete obstruction of the common bile duct and might be one of the causes of delayed eosinophilia, as reported in some kinds of stenotic b a b a bile duct diseases. [7][8][9][10][11][12] The increase of eosinophils might occur through augmentation of eosinophil production at the bone marrow. In these processes, IL-5, which was released from giant cells, might possibly play some role.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Marked infiltration of eosinophils in necrotizing granulomas in the resected hepatic bed after cholecystectomy resulting from gallbladder cancer and metastatic liver cancer is associated with peculiar peripheral eosinophilia

et al. 2012

View full text Add to dashboard Cite

It is known that after transurethral resection of the prostate (TUR-P) or a bladder tumor (TUR-BT), necrotizing granuloma formation associated with massive eosinophil accumulation can be detected at the site of the scar, revealing marked eosinophilia. This condition is called post-TUR prostatitis or cystitis. In the present study, we noticed a similar phenomenon in five patients who underwent cholecystectomy, of whom four had gallbladder adenocarcinoma and one had metastatic liver cancer originating from the rectum. We detected necrotizing granulomas with massive eosinophil accumulation, associated with marked eosinophilia. To induce these phenomena, the interval between the first operation (i.e., cholecystectomy) and the second operation (i.e., resection of the hepatic bed and extrahepatic bile duct) is very important. If the interval was 1 week, no granuloma formation was detected. On the other hand, if it was more than 2 weeks, the resected hepatic bed contained necrotizing granulomas with substantial eosinophil accumulation combined with an increase in peripheral eosinophilia (up to 34% in one case). Secondary resection was necessary to induce eosinophilia after cholecystectomy. In this sense, malignancies possessed a relationship with delayed eosinophilia. In the granulomas, some foreign body-type multinucleated giant cells were positive for both anti-interleukin (IL)-5 and CD68 antibodies. In sharp contrast, no eosinophilia was detected after cholecystectomy, with or without hepatic resection consequent to severe adhesion. Clinicians as well as pathologists should keep in mind that these peculiar phenomena of eosinophil accumulation surrounding the necrotizing granulomas and peripheral eosinophilia after cholecystectomy could occur.

show abstract

Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 99%

Marked infiltration of eosinophils in necrotizing granulomas in the resected hepatic bed after cholecystectomy resulting from gallbladder cancer and metastatic liver cancer is associated with peculiar peripheral eosinophilia

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Considerable effort is often employed to exclude malignancy in such cases, similar to our experience. Peripheral eosinophilia is present in most patients,7 and bone marrow biopsy can demonstrate eosinophilic infiltration as well 8 11. Although this may provide a diagnostic clue to the astute physician, its presence is neither sensitive nor specific and malignancy itself may also lead to eosinophilia 12…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic cholangiopathy: the diagnostic dilemma of a recurrent biliary stricture. Should surgery be offered for all?

et al. 2014

View full text Add to dashboard Cite

SUMMARYA 63-year-old man presented with the initial diagnosis of autoimmune pancreatitis with obstructive jaundice. CT of the abdomen revealed an oedematous pancreas and dilated common bile duct (CBD), without gallstones. After failure of initial retrograde cholangiopancreatography, a percutaneous biliary catheter was inserted with good drainage. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) revealed a 2 cm distal CBD stricture. A biliary stent was inserted past the stricture. Biopsy of the stricture, brush cytology of the bile duct and fine needle aspiration of pancreatic head under endoscopic ultrasound guidance were negative for malignancy. Autoimmune screen was negative as well. However, the patient represented with cholangitis requiring repeat ERCP and insertion of a second biliary stent. He finally underwent cholecystectomy with excision of the distal CBD and Roux-En-Y hepaticojejunostomy. Histology revealed diffuse eosinophilic cholecystitis and cholangitis. A retrospective review of the blood results showed persistent eosinophilia in full blood count measurements from presentation and persisting throughout the treatment period. BACKGROUND

show abstract

“…20 Histological assessment after resection may allow a more precise diagnosis to be made e examples of lesions that can mimic hilar cholangiocarcinoma include IgG4 disease 21 and rarer disorders such as follicular cholangitis, 22 or eosinophilic cholangitis. 23 Unilateral lobar atrophy usually occurs in the setting of combined biliary and portal vein occlusion; a significant correlation exists with ipsilateral portal vein obstruction which may be benign or malignant. 24 Pre-cancerous lesions Study of specimens from patients with predisposing disease of PSC or parasitic infection has identified premalignant changes in biliary epithelium for which the terminology of biliary intraepithelial neoplasia (BilIN) is replacing the more conventional dysplasia.…”

Section: Perihilar and Periductal Infiltrating CCmentioning

confidence: 99%

Cholangiocarcinoma – new concepts and classifications

Wyatt

2011

Diagnostic Histopathology

View full text Add to dashboard Cite

Eosinophilic cholangitis with obstructive jaundice mimicking bile duct carcinoma

Cited by 16 publications

References 9 publications

Marked infiltration of eosinophils in necrotizing granulomas in the resected hepatic bed after cholecystectomy resulting from gallbladder cancer and metastatic liver cancer is associated with peculiar peripheral eosinophilia

Marked infiltration of eosinophils in necrotizing granulomas in the resected hepatic bed after cholecystectomy resulting from gallbladder cancer and metastatic liver cancer is associated with peculiar peripheral eosinophilia

Eosinophilic cholangiopathy: the diagnostic dilemma of a recurrent biliary stricture. Should surgery be offered for all?

Cholangiocarcinoma – new concepts and classifications

Contact Info

Product

Resources

About