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Case Reports
. 2020 Sep 1;59(17):2123-2128.
doi: 10.2169/internalmedicine.4611-20. Epub 2020 May 23.

A Resected Case of Follicular Cholangitis That Was Positive on 18F-fluorodeoxyglucose-positron Emission Tomography

Takashi Kosone  1 , Hitoshi Takagi  1 , Satoshi Takakusagi  1 , Takashi Hoshino  2 , Yozo Yokoyama  1 , Kazuko Kizawa  1 , Kyoko Marubashi  1 , Akira Watanabe  3 , Kenichiro Araki  3 , Norifumi Harimoto  3 , Hayato Ikota  4 , Ken Shirabe  3 , Kenichi Harada  5 , Satoru Kakizaki  6 , Toshio Uraoka  6
Affiliations
Case Reports

A Resected Case of Follicular Cholangitis That Was Positive on 18F-fluorodeoxyglucose-positron Emission Tomography

Takashi Kosone et al. Intern Med. .

Abstract

We experienced a case of follicular cholangitis that was positive on fluorodeoxyglucose-positron emission tomography (18F-FDG-PET). A 70-year-old man was admitted for jaundice. Endoscopic retrograde cholangiography showed stenosis of the middle to upper choledocus. 18F-FDG-PET depicted a localized hot spot at the stenotic lesion (maximum standardized uptake value = 8.2). Although no malignant findings were found in the cytology or on a bile duct biopsy, malignancy could not be excluded, so surgical treatment was performed. Follicular cholangitis is a new, rare disease that causes severe biliary stricture. Only 11 cases of follicular cholangitis have been reported, including the present case.

Keywords: 18F-FDG-PET; biliary stricture; cholangiocarcinoma; follicular cholangitis.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
a: Computed tomography demonstrated the stenosis of the upper part of the choledocus. b: Endoscopic retrograde cholangiography showed the stenotic lesion at the upper part of the choledocus.
Figure 2.
Figure 2.
18F-FDG-PET demonstrated a localized hot spot (SUVmax=8.2) at the upper choledocus without any other organ accumulation.
Figure 3.
Figure 3.
a: Macroscopic appearance of the resected specimen showed upper bile duct fibrotic stenosis without an obvious solid tumor. b: A microscopic examination revealed follicular cholangitis accompanied by a germinal center (Hematoxylin and Eosin staining).
Figure 4.
Figure 4.
Immunostaining of the stenotic lesion of the choledocus. a: IgG1 staining as control, b: IgG4 staining, very few IgG4-positive cells were observed. c: CD10 staining showed lymphoid cells, d: MIB-1staining was positive, e: Maspin staining and p53 staining (f) were negative.
See this image and copyright information in PMC

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