AN AUTOPSY CASE OF PSEUDOSARCOMA OF THE COMMON BILE-DUCT

An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to o ur hospital; he was examined by abdominal ultrasonography (US), reveal ing biliary calculus, dilatation of the common bile duct, and choledoc holithiasis, considered to be the possible cause of the obstructive ja undice. Endoscopic retrograde biliary drainage (ERBD) and cholangiosco py were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complic ations of the liver, infection, and disseminated intravascular coagula tion (DIC). An autopsy study revealed tumor cells with extreme pleomor phic changes, growing diffusely, very like sarcoma. Further examinatio n revealed epithelioid arrangements in the metastatic lymph node. Twel ve kinds of immunohistochemical examination showed a positive reaction , reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japane se literature, only 1 case was reported, in 1990, to involve the commo n bile duct. We therefore report the present case of pseudosarcoma of the common bile duct.