Case #263 - November, 2009
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A 35-year-old man from Nepal presented at a hospital with recurring cholangitis; the patient had been experiencing symptoms for the previous six months. An MRI revealed two lesions in the liver, measuring approximately 5 centimeters long by 2 centimeters wide. Both lesions had cystic as well as solid components. An endoscopic retrograde cholangiopancreatography (ERCP) was also performed in the common bile duct, revealing flat leaf-shaped objects (Figures A-B). The objects were removed and collected in 10% formalin; they measured on average two centimeters in length (Figure C). One of the specimens was sent to a reference laboratory for identification, where it was stained with carmine (Figure D). What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.
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