Primary signet-ring cell carcinoma of the extrahepatic bile duct: A case report

Figure 1 Contrast-enhanced computed tomography and percutaneous transhepatic cholangiopancreatic drainage images. A and B: Contrast-enhanced computed tomography (CECT) of the abdomen shows that the common bile duct wall is thickened and strengthened (arrows) with enlarged lymph nodes (asterisks); C: CECT shows intrahepatic bile duct dilation (arrows) and multiple liver metastases (asterisks); D and E: Percutaneous transhepatic cholangiopancreatic drainage shows a vine-like expansion of the intrahepatic bile duct (D, arrows) and segmental stenosis of the extrahepatic bile duct (E, arrows); F: A biliary biopsy was performed under fluoroscopy (arrows).

Figure 2 Primary signet ring cell carcinoma of the extrahepatic bile duct. A: Hematoxylin and eosin staining (× 400), showing signet ring cells (arrows) with abundant intracytoplasmic vacuoles and peripherally displaced nuclei (red arrows); B-F: Immunohistochemistry staining (× 400), CK19, CAM5.2, CK7, CEA, and PAS-positive staining, respectively.

Figure 3 Timeline. SRCC: Signet ring cell carcinoma; PTCD: Percutaneous transhepatic cholangiopancreatic drainage.

Figure 4 Flowchart of the literature screening process for primary signet ring cell carcinoma of the extrahepatic bile duct. SRCC: Signet ring cell carcinoma.