Radiological Approach to Diagnosis of Peribiliary Lesions

Peribiliary region is the anatomical space adjoining the intra and extrahepatic biliary system and comprises of portal vein, hepatic artery, nerves and lymphatics. This region is prone to several pathologies ranging from congenital, infective, inflammatory, traumatic and neoplastic. Due to the wide spectrum of abnormalities, it is often difficult to reach a final diagnosis. This review focusses to draw a roadmap to help reach a diagnosis of abnormalities encountered in this region by highlighting the characteristic imaging features associated with these abnormalities.

Clear cell sarcoma like tumor of gastrointestinal tract: Experience of three cases and review of literature

Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSGT) is a rare, aggressive tumor with many histological mimickers. Herein, we have documented our experience of three cases of CCSGT and reviewed the literature. The index cases were identified in male patients in their twenties, one in jejunum and two in the distal colon. Histomorphological examination revealed the characteristic heterogeneous histomorphology with patchy immunohistochemical positivity with S100 protein and negative melanocytic markers. The fluorescence in-situ hybridization test showed translocation of the EWSR1 (22q12) gene in >80% tumor cells. While one of our patients died after 2 years with lung metastasis, the other two patients are still alive on 1.5 years and 3 months follow up, respectively. CCSGT is a rare malignant tumor of the gastrointestinal tract. Although characteristic morphology, use of a judicial panel of immunohistochemical stains, and translocation study for EWSR1 gene can establish the diagnosis, experience in adjuvant therapy is still limited.

Duplication of the Gallbladder: A Rare Congenital Anomaly

Biliary tract shows a large number of anatomic variations and duplication of the gallbladder (GB) is a rare congenital anomaly. Although it is very often detected incidentally, it may present with complications due to gall stone disease. Careful identification of this anomaly on imaging is important to prevent any serious surgical complications. We here report a case of duplicated GB in a 26-year-old male, who presented with right hypochondriac pain and detected to have two GB on magnetic resonance imaging (MRI).