An Uncommon Cause of Obstructive Jaundice: An Infrequent Neoplasm

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An Uncommon Cause of Obstructive Jaundice: An Infrequent Neoplasm Kathleen Tompkins, MD, Genevieve M. Crane, MD, PhD, Stefan L. Zimmerman, MD, Allan C. Gelber, MD The American Journal of Medicine Volume 130, Issue 2, Pages e43-e45 (February 2017) DOI: 10.1016/j.amjmed.2016.08.027 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Coronal image from contrast-enhanced computed tomography examination of the abdomen obtained in the portal venous phase demonstrates a soft tissue mass in the hepatic hilum (arrows), located superior to the duodenum and pancreatic head, resulting in obstruction and dilation of the common bile duct (arrowhead). The American Journal of Medicine 2017 130, e43-e45DOI: (10.1016/j.amjmed.2016.08.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Axial computed tomography image demonstrates a rounded low-attenuation mass in the medial right hepatic lobe (arrow) adjacent to the hilar mass (asterisk) and several low-attenuation splenic lesions (arrowheads). The American Journal of Medicine 2017 130, e43-e45DOI: (10.1016/j.amjmed.2016.08.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Hematoxylin-eosin-stained section of cell block material from the patient's initial fine-needle aspiration procedure demonstrated large, atypical lymphoid cells with prominent nucleoli and scant to moderate cytoplasm with numerous apoptotic cells and necrotic debris, diagnostic of B-cell lymphoma. The American Journal of Medicine 2017 130, e43-e45DOI: (10.1016/j.amjmed.2016.08.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 A subsequent core biopsy section of the hilar mass demonstrated the large atypical lymphoid cells were positive for Epstein-Barr virus. Additional immunohistochemical stains demonstrated the cells were positive for CD20, CD10, and BCL-6 (not shown). The American Journal of Medicine 2017 130, e43-e45DOI: (10.1016/j.amjmed.2016.08.027) Copyright © 2016 Elsevier Inc. Terms and Conditions