Figure legends
Figure. 1
CECT scan of the abdomen showed thickening of the walls of the middle to
distal bile ducts (arrow) and dilated intrahepatic bile ducts. No mass
was evident around the bile duct wall.
CECT, contrast-enhanced computed tomography
Figure. 2
MRI showed a mass-like lesion around the head of the pancreas that was
hyperintense on diffusion-weighted imaging(arrow).
MRI, magnetic resonance imaging
Figure. 3
ERCP showed severe stenosis in a relatively long area of the middle to
distal bile ducts.
ERCP, endoscopic retrograde cholangiopancreatography
Figure. 4
Intraductal ultrasonography showed a homogeneous circumferential
thickening (iso-to hyperechoic) of the bile duct wall at the site of the
stenosis was observed.
Figure. 5
Findings on histopathological examination of the biopsy specimen were
suggestive of adenocarcinoma(5-1), and immunostaining of the same
specimen showed GATA3(5-2), HER2(5-3), and mammaglobin(5-4) positivity.
Figure. 6
A plastic stent in the bile duct was replaced with a SEMS.
SEMS, self-expandable metallic stent
Figure. 7
A plastic stent was placed into the SEMS because tumor invasion was
suspected.
SEMS, self-expandable metallic stent
Figure. 8
An additional SEMS was placed in the form of a stent-in-stent because of
severe stenosis in the SEMS due to tumor invasion.
SEMS, self-expandable metallic stent