Nodular Lymphoid Hyperplasia Masquerading as Neoplasia of the Bile Duct and Pancreas

Context Nodular lymphoid hyperplasia is a disease may that occur in multiple locations including the gastrointestinal tract. Few reports exist on the occurrence in the hepatopancreaticobiliary system, and yet this has not been reported in the bile duct. Case report A fiftyseven-year-old male presented with painless jaundice, intra-hepatic biliary dilatation and a lesion in the distal pancreas (as shown in the computed tomography scan). The endoscopic retrograde cholangiopancreatogram findings were consistent with Bismuth II Klatskin type tumor. The patient underwent surgical resection of both lesions. The pathological analysis demonstrated reactive nodular hyperplasia in both the pancreas and bile duct. Conclusion Nodular lymphoid hyperplasia is a rare, benign disease of the hepatopancreaticobiliary tree and is most often diagnosed at the time of surgical resection, secondary to an inability to exclude neoplasia. Awareness regarding this rare disease entity may change patient management. Received May 04th, 2015-Accepted June 26th, 2015