{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T07:50:58Z","timestamp":1773733858548,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Eosinophilic cholangitis (EC) has a low clinical incidence, and cases with definitive pathological confirmation are extremely rare. Due to the lack of specificity in clinical and radiologic features, EC is frequently misdiagnosed as cholangiocarcinoma. We report a 65-year-old man admitted with progressive jaundice and persistent dull right upper-quadrant abdominal pain for more than 1 month. Laboratory tests showed a markedly elevated peripheral blood eosinophil count, significantly elevated bilirubin levels, and elevated tumor markers. MRI revealed intra- and extrahepatic bile duct dilatation and common bile duct wall thickening. Cholangiocarcinoma was initially suspected. A radical pancreaticoduodenectomy was planned. However, intraoperative exploration showed edema and induration of the bile duct and pancreas. Therefore, the radical resection was aborted, and bile duct wall biopsy alone was performed for pathological diagnosis. Postoperative histopathology revealed dense eosinophilic infiltration in the bile duct wall (&amp;gt;20 eosinophils per high-power field), confirming the diagnosis of EC. After postoperative standard methylprednisolone therapy, the patient achieved complete symptom resolution. Laboratory indices returned to the normal range, and no recurrence was observed during the 3-month follow-up. This case highlights that EC should be suspected in biliary obstruction with unexplained eosinophilia, and histopathology is the key to definitive diagnosis.<\/jats:p>","DOI":"10.3389\/fonc.2026.1791076","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:26:36Z","timestamp":1773725196000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Eosinophilic cholangitis misdiagnosed as cholangiocarcinoma: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Yabo","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, Gansu Provincial Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Gansu Provincial Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhua","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Gansu Provincial Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Gansu Provincial Hospital","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/906496","article-title":"Eosinophilic cholangitis and cholangiopathy: a sheep in wolves clothing","volume":"2010","author":"Nashed","year":"2010","journal-title":"HPB Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i13.1995","article-title":"A case of eosinophilic cholangitis: imaging findings of contrast-enhanced ultrasonography, cholangioscopy, and intraductal ultrasonography","volume":"13","author":"Matsumoto","year":"2007","journal-title":"World J Gastroenterol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07923.x","article-title":"Eosinophilic cholecystitis","volume":"146","author":"Leegaard","year":"1980","journal-title":"Acta Chir Scand"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2856-6","article-title":"Eosinophilic cholangiopathy--a case report","volume":"50","author":"Duseja","year":"2005","journal-title":"Dig Dis Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2271010938","article-title":"Case 57: eosinophilic cholangiopathy","volume":"227","author":"Vauthey","year":"2003","journal-title":"Radiology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21405","article-title":"Sclerosing cholangitis: a focus on secondary causes","volume":"44","author":"Abdalian","year":"2006","journal-title":"Hepatology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.41526.x","article-title":"Secondary sclerosing cholangitis: a comparison to primary sclerosing cholangitis","volume":"100","author":"Gossard","year":"2005","journal-title":"Am J Gastroenterol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282f1cc11","article-title":"Eosinophilic cholangiopathy with concurrent eosinophilic colitis in a patient with idiopathic hypereosinophilic syndrome","volume":"20","author":"Sussman","year":"2008","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e2394","DOI":"10.1097\/MD.0000000000002394","article-title":"Eosinophilic cholangitis--A challenging diagnosis of benign biliary stricture: A case report","volume":"95","author":"Fragulidis","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1111\/hepr.12380","article-title":"Eosinophilic cholangitis coexisted with idiopathic thrombocytopenic purpura: Report of a case","volume":"45","author":"Hokuto","year":"2015","journal-title":"Hepatol Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199703000-00015","article-title":"Eosinophilic cholangitis: US,CT,and cholangiography findings","volume":"21","author":"Song","year":"1997","journal-title":"J Comput Assist Tomogr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1148\/radiographics.20.4.g00jl04959","article-title":"Radiologic manifestations of sclerosing cholangitis with emphasis on MR cholangiopancreatography","volume":"20","author":"Vitellas","year":"2000","journal-title":"Radiographics"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.787422","article-title":"The Role of IgG4 in Autoimmunity and Rheumatic Diseases","volume":"12","author":"Maslinska","year":"2022","journal-title":"Front Immunol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2020.1859710","article-title":"Research Program for Intractable Disease by the Ministry of Health, Labor and Welfare (MHLW) Japan. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD","volume":"31","author":"Umehara","year":"2024","journal-title":"Mod Rheumatol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-7687-6_9","article-title":"Elevated serum level of carbohydrate antigen 19\u20139 in benign biliary stricture diseases can reduce its value as a tumor marker","volume":"7","author":"Lin","year":"2014","journal-title":"Int J Clin Exp Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/136518201753242280","article-title":"Eosinophilic cholangitis: a case of \u2018malignant masquerade\u2019","volume":"3","author":"Rodgers","year":"2001","journal-title":"HPB (Oxford)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-008-0041-y","article-title":"Eosinophilic cholangitis with obstructive jaundice mimicking bile duct carcinoma","volume":"16","author":"Chen","year":"2009","journal-title":"J Hepatobil Pancreat Surg"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1055\/a-2481-7048","article-title":"Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"57","author":"Facciorusso","year":"2025","journal-title":"Endoscopy"},{"key":"B19","doi-asserted-by":"publisher","first-page":"451036","DOI":"10.21608\/ejhm.2025.451036","article-title":"Diagnostic and therapeutic roles of endoscopic ultrasound in gastroenterology: an overview","volume":"88","author":"ElSayed","year":"2025","journal-title":"Egypt J Hosp Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2019.08.002","article-title":"Eosinophilic cholangitis with eosinophilic granulomatosis with polyangiitis: A case report and review of the literature","volume":"69","author":"Yoshihara","year":"2020","journal-title":"Allergol Int"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e01641","DOI":"10.14309\/crj.0000000000001641","article-title":"Rare Presentation of Eosinophilic Cholangitis in a 32-Year-Old Man","volume":"12","author":"Khataniar","year":"2025","journal-title":"ACG Case Rep J."}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1791076\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:26:37Z","timestamp":1773725197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1791076\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":21,"alternative-id":["10.3389\/fonc.2026.1791076"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1791076","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"article-number":"1791076"}}