Primary Sclerosing Cholangitis Associated With Ulcerative Colitis Coexisting With Cholangiocarcinoma: A Case Report.

Primary sclerosing cholangitis (PSC) is a rare chronic inflammatory disease in which multifocal fibrosis of bile ducts causes eventually narrowing and even blocking, forming multifocal strictures alternated to dilatations. Here, we reported an extremely rare case of PSC associated with ulcerative colitis (UC) and coexisting with cholangiocarcinoma in a 33-year-old male presented with right upper quadrant pain and dark urine. Liver function tests were deranged, and ERCP found a beaded cholangiography appearance due to multifocal bile duct strictures alternating with normal and dilated segments of the common hepatic duct and the intrahepatic bile ducts. We aim to document this typical case of PSC associated with UC and coexisted with cholangiocarcinoma to add the existing data on these rare pathologies.

Predictive value of ultrasound imaging in differentiating benign from malignant breast lesions taking biopsy results as the standard.

BACKGROUND: Breast lesions (BLs) are abnormal swellings within the breast. The importance lies in need to exclude breast cancer. OBJECTIVE: Due to the role of ultrasound (US) imaging in evaluating of BLs, this study was conducted to evaluate the predictive value of US imaging for differentiating benign from malignant BLs and to assess the need of biopsy in BLs. METHOD: A retrospective review of diagnostic results of 134 patients with BLs. All patients underwent breast US imaging and US-guided biopsy for cytology or histopathology. The results of both were compared. RESULTS: Out of 134 patients were included in this study, the mean age was 38.45 ± 15.82 years (range, 18-90 years), and all patients were female. BLs were benign in 99 cases (73.9%) and malignant in 35 cases (26.1%). Among 98 patients with BLs diagnosed benign with US, 96.9% were confirmed benign with biopsy results and only 3.1% were malignant. The overall sensitivity of US imaging for discriminating of benign BLs was 95.95%, with a specificity of 91.42%, and positive predictive value of 96.94%. The results revealed strong compatibility between diagnoses by US imaging and biopsy results (P < 0.001), the measure of agreement kappa = 0.866, and the Spearman's correlation coefficient = 0.866. CONCLUSION: US imaging is a highly valuable imaging method in differentiating benign from malignant BLs. It usually predicts the benign nature of BLs with excellent diagnostic accuracy. US-guided fine-needle aspiration and core-needle biopsies are not necessary in most cases of BLs.