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A Journal on Surgery

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Chirurgia 1999 December;12(6):451-6

language: English

Non-Hodgkin's lymphoma presenting as severe jaundice by extrahepatic biliary obstruction

Zanotti M., Perone C., Merloni T., Musazzi M., Prada A., Pavia G., Sartirana A.

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Extrinsic compression of the common bile duct by enlarged lymph nodes is an unusual cause of obstructive jaundice. We report one patient with such manifestation of lymphoma and we describe the use of ultrasound (US), CT, endoscopic retrograde cholangiopancreatography (ERCP) and ultrasonically-guided fine-needle biopsy in distinguishing this rare complication from other causes of jaundice. Our patient had clinical, biochemical and roentgenographic evidence of cholestatic jaundice due to biliary obstruction. A biliary plastic stent bypassing the obstruction was positioned endoscopically and the patient had a rapid resolution of both symptoms and biochemical abnormalities by nonoperative biliary bypass. Ultrasonically-guided fine-needle biopsy was a diagnostic tool. The limited experience described herein suggests that biliary obstruction may thus indicate a poor prognosis in non-Hodgkin's lymphoma.

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