A case of primary sclerosing cholangitis in which the critical diagnostic role of bile duct brush cytology obtained by ERCP was revealed

Abstract

Background : Primary sclerosing cholangitis (PSC) is a rare disease with a poor prognosis.

Case : Herein, we present the case of a male patient in his 30 s with ulcerative colitis, who presented to us with abnormal liver function test results, elevated biliary enzyme levels, and prominent biliary strictures. We confirmed the diagnosis of PSC by liver biopsy. While the initial biliary cytology was benign, atypical cells were found in the subsequent cytology specimen. We considered adenocarcinoma of the bile duct in the differential diagnosis. However, there was no prominent hyperchromasia and the cytology was classified as suspicious.

Conclusion : Bile duct brushing cytology by endoscopic retrograde cholangiopancreatography (ERCP) could play a critical role in the diagnosis of PSC.