Precise mapping of hilar cholangiocarcinoma with a skip lesion by SpyGlass cholangioscopy: A case report

Figure 1 Imaging results. A: Abdominal sonography showed dilated intrahepatic ducts (arrow); B: The cholangiogram revealed a long filling defect (arrow) from the proximal common bile duct (CBD) to the common hepatic duct; C: Contrast-enhanced computed tomography also showed soft tissue density (arrow) from the proximal CBD to the common hepatic duct; D: Percutaneous transhepatic cholangiography drainage (arrow) was performed on the left intrahepatic duct to alleviate jaundice.

Figure 2 SpyGlass cholangioscopy. A: SpyGlass cholangioscopy showed one intraductal mass that involved bifurcation of the intrahepatic ducts; B: The far view of the skip lesion in the right posterior branch of the bile duct; C: The near view of the skip lesion, which was 2 cm proximally away from bifurcation of the common hepatic duct; D: Normal appearance of the mucosa in the proximal left intrahepatic duct.

Figure 3 The macroscopic and microscopic images of the lesions. A: The main cholangiocarcinoma lesion (arrow) and skip lesion (arrowhead); B: Pathology of cholangiocarcinoma (hematoxylin and eosin, × 200 magnification).