A Case of Primary Small Cell Carcinoma of the Common Bile Duct

Isamu Makino, Hirohisa Kitagawa, Tetuo Ota, Masato Kayahara, Genichi Nishimura, Takashi Fujimura, Koichi Shimizu, Koichi Miwa, Katuaki Sato* and Yoshio Oda*

Department of Gastroenterological Surgery, Department of Pathology*, Kanazawa University School of Medicine

A 74 year-old man admitted for jaundice was found in diagnostic imaging to have a growing papillary tumor occupying the lumen of the lower bile duct. We diagnosed it as lower bile duct cancer without invasion to other organs, lymph node metastasis, liver metastasis, or distant metastasis, suggesting it could be curatively resected. Though we attempted to improve jaundice before surgery with PTCD, it was persisted and his liver function gradually worsened. He died of liver failure 3 months after admission. Autopsy showed a yellowish expanded papillary tumor in the lower bile duct, 3 metastatic nodules in the liver, and one on the omentum. Histopathological specimens showed undifferentiated round cells arranged crowded or in uncertain gland pattern. In immunohistological studies, granules stained with chromogranin A, Grimelius, CD56, or CAM in the cytoplasm of the cancer cells, and the tumor was diagnosed as small cell carcinoma arising primarily in the common bile duct.

Key words
small cell carcinoma, common bile duct

Reprint requests
Isamu Makino Department of Gastroenterological Surgery, Kanazawa University School of Medicine
13-1 Takaramachi, Kanazawa, 920-8641 JAPAN

Accepted
January 28, 2004

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