A case of localized primary sclerosing cholangitis mimicking intrahepatic bile duct cancer

A 75-year-old woman with chronic hepatitis was regularly followed-up in our hospital. A computed tomography (CT) scan revealed an obviously enlarged i ntrahepatic bile duct in the posterior branch of the left lateral segment. Percutaneous cholangiography revealed an enlarged posterior branch of the l eft lateral segment and a narrow stenotic region at the root of this branch . We diagnosed her as having intrahepatic bile duct cancer, and a left late ral segmentectomy of the liver was performed. However, microscopic examinat ion of the resected specimens revealed peribiliary fibrosis in the stenotic bile duct and other areas of the intrahepatic bile duct with no malignant cells. Thus, the final diagnosis was made to be primary sclerosing cholangi tis. We must consider primary sclerosing cholangitis in the differential di agnosis of localized stenosis of the intrahepatic bile duct. (C) 2001 Elsev ier Science Ireland Ltd. All rights reserved.