<p>Diagnostic challenges in biliary cytology of biliary inflammatory pseudotumor of the liver: A case report and a review of the literature</p>

Higuchi,Yumiko; Kato,Toshihiko; Kurihara,Eishin; Toyama,Tomonari; Fusegawa,Takuya; Ubukata,Mami; Yoshizawa,Tomiko; Imaizumi,Tomohiro; Otake,Yosuke; Sugihara,Shiro; Tani,Noriyuki; Imai,Yasuo

doi:10.3892/mi.2026.303

March-April 2026 Volume 6 Issue 2

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March-April 2026 Volume 6 Issue 2

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Case Report Open Access

Diagnostic challenges in biliary cytology of biliary inflammatory pseudotumor of the liver: A case report and a review of the literature

Authors:
- Yumiko Higuchi
- Toshihiko Kato
- Eishin Kurihara
- Tomonari Toyama
- Takuya Fusegawa
- Mami Ubukata
- Tomiko Yoshizawa
- Tomohiro Imaizumi
- Yosuke Otake
- Shiro Sugihara
- Noriyuki Tani
- Yasuo Imai
View Affiliations / Copyright

Affiliations: Department of Diagnostic Pathology, Ota Memorial Hospital, SUBARU Health Insurance Society, Ota, Gunma 373‑8585, Japan, Department of Gastroenterology, Ota Memorial Hospital, SUBARU Health Insurance Society, Ota, Gunma 373‑8585, Japan, Department of Clinical Laboratory, Gunma Prefectural Cancer Center, Ota, Gunma 373‑8550, Japan, Department of Central Clinical Laboratory, Kiryu Kosei General Hospital, Kiryu, Gunma 376‑0024, Japan, Department of Surgery, Ota Memorial Hospital, SUBARU Health Insurance Society, Ota, Gunma 373‑8585, Japan

Copyright: © Higuchi et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
Article Number: 19
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Published online on: February 18, 2026

https://doi.org/10.3892/mi.2026.303
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Abstract

Biliary inflammatory pseudotumor (IPT) of the liver is a rare benign tumor of which radiographic images, such as biliary stricture and dilatation, resemble those of cholangiocarcinoma (CC). Although repeated biliary cytology via endoscopic nasobiliary drainage (ENBD) is performed for differential diagnosis, a correct diagnosis remains difficult. The present study describes the case of a 76‑year‑old female patient with chronic liver disease. During surveillance, intrahepatic CC was suspected by imaging analyses; however, the carcinoembryonic antigen and CA19‑9 levels were within normal ranges. Percutaneous core needle biopsy was not performed due to technical reasons; however, a left lobectomy was performed based on the diagnosis of malignancy by ENBD bile cytology. A pathological examination of the resected liver demonstrated biliary IPT. Reflecting on the cytological diagnosis of this case, a multi‑reviewer re‑evaluation of the biliary cytology of this IPT case and 2 cases of well‑differentiated CC was then performed, which demonstrated difficulty in distinguishing between them. On the whole, ENBD cytology can play a limited role in differentiation between benign and malignant bile strictures. Surgical indication should be carefully determined and percutaneous core needle biopsy may be warranted in patients with normal tumor marker levels.

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Diagnostic challenges in biliary cytology of biliary inflammatory pseudotumor of the liver: A case report and a review of the literature

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Abstract

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