A woman in her 70s presented to an Australian centre with right upper quadrant pain, fevers and weight loss. She was born in Greece, having lived in Australia for 50 years. Significant background included chronic lymphocytic leukaemia (CLL), treated with venetoclax and rituximab. Her white cell count was 3.20×109/L with normal liver function tests, bilirubin of 6 µmol/L and C reactive protein of 15 mg/L. Cross-sectional imaging with CT found intrahepatic, extrahepatic, common bile duct dilatation (CBD) to 11 mm, pancreatic duct dilatation to 6 mm (a ‘double duct’ sign) and prominent para-aortic, coeliac and porta lymph nodes (figure 1A). Tumour markers including CA19-9 were normal. She was treated with intravenous ceftriaxone and metronidazole …

中文翻译：

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胰头肿块伴胆道梗阻：罕见原因

一名 70 多岁的女性因右上腹疼痛、发烧和体重减轻到澳大利亚中心就诊。她出生于希腊，在澳大利亚生活了 50 年。重要背景包括用维奈托克和利妥昔单抗治疗的慢性淋巴细胞白血病（CLL）。白细胞计数3.20×109/L，肝功能正常，胆红素6μmol/L，C反应蛋白15mg/L。 CT 横断面成像发现肝内、肝外胆总管扩张 (CBD) 至 11 毫米，胰管扩张至 6 毫米（“双管”征象）以及明显的主动脉旁、腹腔和门淋巴结（图 1A） ）。包括CA19-9在内的肿瘤标志物均正常。她接受了静脉注射头孢曲松和甲硝唑治疗……