[An anatomical case of obstructive jaundice due to the rapid enlargement of hepatic peribiliary cysts in end-stage alcoholic liver cirrhosis].

A man in his 60s had end-stage alcoholic cirrhosis. About six months before his death, hepatic peribiliary cysts (HPBC) rapidly increased, and he developed jaundice and liver failure. The pathological autopsy performed after his death revealed that his intrahepatic bile duct was pressured due to multiple cysts caused by HPBC, which resulted in liver failure. Some cases of HPBC have been associated with alcoholic cirrhosis;however, no other cases of increased HPBC in a short period of time have been reported. Although identifying the cause of increased HPBC in a short time is difficult in this case, it may be have been caused by continuous alcohol drinking after the onset of HPBC. Most patients with HPBC have liver cirrhosis and obstructive jaundice that may promote liver failure as in this case. Therefore, patients with HPBC should not only be instructed for abstinence but also promptly consider effective treatments in the event of obstructive jaundice to prevent liver dysfunction.

Duodenal diverticulum metastasis from pulmonary squamous cell carcinoma diagnosed by EUS-FNA.

A 76-year-old male with pulmonary squamous cell carcinoma achieved complete response by chemoradiotherapy and subsequent systemic chemotherapy. During follow-up, fluorodeoxyglucose positron emission tomography/computed tomography showed strong fluorodeoxyglucose accumulation near the duodenal papilla. Elevated lesions were observed in the duodenal diverticulum upon lateral-viewing endoscopy, and a curved linear array echoendoscope showed a hypoechoic mass. Since it was difficult to obtain adequate tissue samples by endoscopic biopsy, endoscopic ultrasound-guided fine needle aspiration was performed for the hypoechoic mass. The pathological findings were squamous cell carcinoma, which was similar to the past histology of primary lung cancer. These findings indicated the diagnosis of duodenal diverticulum metastasis from pulmonary squamous cell carcinoma. Duodenal metastasis of pulmonary squamous cell carcinoma is a rare disease, and there have been no reports of duodenal diverticulum metastasis.