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Related Experiment Video

Updated: Jan 20, 2026

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Decoding follicular cholangitis: A benign entity with a malignant façade.

Arshi Tandon1, Kirti Rajput1, Surbhi Goyal1

  • 1Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

Indian Journal of Pathology & Microbiology
|January 19, 2026
PubMed
Summary
This summary is machine-generated.

Follicular cholangitis (FC), a rare benign biliary condition, can mimic cancer. Frozen section analysis during surgery is crucial for accurate diagnosis, enabling conservative treatment and avoiding unnecessary extensive resections.

Keywords:
Bile ductcholangiocarcinomafollicular cholangitisfrozen sectionlymphoid aggregates

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Pathology

Background:

  • Follicular cholangitis (FC) is a rare benign inflammatory biliary disorder.
  • FC can present with imaging findings suggestive of malignancy, posing diagnostic challenges.

Purpose of the Study:

  • To highlight the diagnostic utility of intraoperative frozen section analysis in differentiating FC from periampullary malignancy.
  • To emphasize the importance of accurate diagnosis for guiding appropriate surgical management and minimizing patient morbidity.

Main Methods:

  • Case presentation of a 34-year-old female with an incidentally detected distal common bile duct (CBD) lesion.
  • Utilized preoperative imaging, serology, biopsy, and intraoperative frozen section analysis.
  • Surgical approach guided by histopathological findings.

Main Results:

  • Preoperative findings were inconclusive, suggesting periampullary malignancy.
  • Intraoperative frozen section analysis revealed cholangitis with lymphoid aggregates, ruling out malignancy.
  • Histopathology confirmed FC and excluded IgG4-related sclerosing cholangitis and primary sclerosing cholangitis (PSC).

Conclusions:

  • Intraoperative frozen section analysis is critical for distinguishing FC from malignancy.
  • Accurate diagnosis facilitates a conservative surgical approach, reducing unnecessary resection and morbidity.
  • Increased awareness and integration of clinical, radiologic, and histopathologic findings are essential for optimal FC management.