THE ROLE OF CHOLANGIOSCOPY BY USING THE SPYGLASS SPYSCOPE SYSTEM IN A PATIENT WITH PRIMARY SCLEROSING CHOLANGITIS (PSC) FOR DIAGNOSING INDETERMINATE BILLIARY STRICTURE

We performed cholangioscopy with the SpyGlass system (Boston Scientific Inc., Massachusetts, USA) and obtained targeted tissue specimens in order to investigate a stricture of 1.7cm at the bifurcation of the common hepatic duct in a 61 years old patient with PSC. We visualized the stricture, obtained tissue specimens with the special biopsy forcep (Spybite) in order to establish diagnosis. Cholangioscopy revealed localized lesions with villous appearance and irregularly dilated vessels, macroscopic signs that suggest neovascularization and possible neoplasia. Despite the suspicion for cholangiocarcinoma, histopathological analysis revealed a localized inflammatory reaction and a fibrotic stricture without any evidence of malignancy.