Hadjimichael E1,2, Fielding DE1,2, Ilyas M1,2,3, Zaitoun AM1,2, Lobo DN2* and Kaye PV1,2
1Department of Cellular Pathology, University of Nottingham, UK
2Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK
3Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
Although liver granulomata mimicking metastatic nodules have been reported previously, these have not been related to previous percutaneous transhepatic cholangiography and biliary drainage. We describe four cases where necrotising granulomata, apparently secondary to previous PTBD, have necessitated liver biopsy and frozen section examination at the time of subsequent planned cancer resection, to exclude tumour metastases. Necrotising granulomata were diagnosed on frozen section in 3 patients, but in one, frozen section offered a diagnosis of malignancy with necrosis, but paraffin sections showed features of a necrotising granuloma. Knowledge of this potential pitfall, with surgeons and pathologists being aware of these lesions caused by PTC, should help prevent misinterpretation.
Pancreaticobiliary cancer; Liver nodules; percutaneous transhepatic cholangiography; Liver granulomata; Metastases; Frozen section
Hadjimichael E, Fielding DE, Ilyas M, Zaitoun AM, Lobo DN, Kaye PV. Liver Nodules after Percutaneous Transhepatic Biliary Drainage: A Case Series. Clin Oncol. 2018; 3: 1457.