Primary T-cell rich B-cell lymphoma of the common bile duct

摘要: A 34-year-old woman was hospitalized for the investigation of a one-month history intestinal disorders, gastric heaviness and transitory icteric episodes. Extensive clinical investigations suggested diagnosis gall bladder carcinoma or sclerosing cholangitis. At laparotomy, proximal part common bile duct markedly thickened by white, firm, fish-flesh like tumour extending in to cystic duct, wall liver. Histological study showed diffuse lymphoid proliferation mainly composed small cells mixed with scattered large atypical cells. Immunohistochemistry revealed that most expressed T-cell markers predominant CD 4 α-Β receptors without phenotypic gap, whereas monotypic B phenotype co-expression Μ δ heavy chains light λ chain restriction. No evidence primary nodal lymphoma found during extensive clinical, radiological, sonographic scanographic examinations. Sequential chemotherapy (MACOP-B) instituted patient still alive years after diagnosis. Morphological immunohistochemistry findings fulfilled criteria high grade B-cell (centroblastic type, Kiel classification) from concealed numerous reactive T-cells, so called rich lymphoma, not previously described this location.