Case of Intraductal Papillary Neoplasm of the Bile Duct Derived from a Hepatic Hilar Cholangiocarcinoma Diagnosed with Peroral Cholangioscopy (SpyGlass^TM)

Abstract

The patient was a 71-year-old man with a chief complaint of fever. He was referred to our hospital because upper intrahepatic bile ducts extending into the porta hepatis and superior bile duct stricture were found in abdominal ultrasonography. Computed tomographic scan and magnetic resonance imaging showed the same findings. Endoscopic retrograde cholangiopancreatography showed a continuous bile duct stricture from 2 cm in the porta hepatis and superior bile ducts. The pathological evaluation did not produce a diagnosis. SpyGlass^TM view revealed an irregular granular papillary stricture with white mucus. We performed biopsy with SpyBite from the tumor papilla. We diagnosed intraductal papillary neoplasm of the bile duct derived from a hepatic hilar cholangiocarcinoma by using SpyGlass.