A case of early bile duct cancer with cholesterolosis of the bile duct diagnosed by peroral cholangioscopy

Abstract

A 75-year-old man was admitted to our hospital for further examination of an intraductal lesion of the bile duct. Peroral cholangiography (POCS) revealed 2 yellowish protruding lesions in the lower bile duct. These lesions were diagnosed as cholesterol polyps and were surrounded by rough mucosa. Cytology indicated adenocarcinoma, so pancreatoduodenectomy was performed. Pathological diagnosis was dysplasia and carcinoma in situ (CIS) localized to the lower bile duct, and CIS was detected at the same region as cholesterosis of the bile duct with no metastasis. POCS was useful, allowing direct observation of the cholesterosis and rough mucosa and cytological diagnosis of early-stage bile duct cancer under direct observation of the rough mucosa.