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巨大胆囊腺瘤误诊为胆囊癌1例报告

王悦华 江华 滕梁红 段焕利 崔壁霄 王冬梅

引用本文:
Citation:

巨大胆囊腺瘤误诊为胆囊癌1例报告

DOI: 10.12449/JCH240424
基金项目: 

教育部人文社会科学研究规划基金项目 (14YJAZH083)

伦理学声明:本例报告已获得患者知情同意。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:王悦华、江华负责病例诊疗及文章的撰写;滕梁红、段焕利负责病理分析;崔壁霄负责影像资料分析;王冬梅负责病例随诊及文献整理。
详细信息
    通信作者:

    王悦华, wangyuehua301@sina.com (ORCID: 0000-0003-4707-3912)

Giant adenoma of the gallbladder misdiagnosed as gallbladder carcinoma: A case report

Research funding: 

Humanities and Social Sciences Planning Fund Project of Ministry of Education (14YJAZH083)

More Information
  • 摘要: 1例胆囊肿物患者,曾出现一过性黄疸,经腹部超声、增强CT、MRCP及PET-CT检查,均诊断为胆囊癌。手术探查见胆囊增大,胆囊颈部肿物挤压肝门部,但没有肿瘤侵犯表现,肝脏未见肿瘤转移征象,仅为患者行胆囊切除术。病理诊断为胆囊管状腺瘤,未见癌变。本病例特点是胆囊肿瘤巨大,影像未见肿瘤边缘浸润,病理未见恶变。

     

  • 图  1  增强CT检查结果

    注: a,胆囊肿瘤压迫肝门部;b,胆囊肿瘤位于胆囊颈部。

    Figure  1.  Results of enhanced CT scan

    图  2  MRCP检查结果

    注: a,胆囊肿瘤压迫肝门部;b,胆囊肿瘤位于胆囊颈部。

    Figure  2.  Results of MRCP

    图  3  PET-CT检查结果

    注: a,全身扫描;b,胆囊肿物表现。

    Figure  3.  Results of PET-CT

    图  4  胆囊大体表现

    注: a,术中所见胆囊;b,切除的胆囊标本及肿物。

    Figure  4.  General manifestations of the gallbladder

    图  5  胆囊肿瘤病理形态学表现

    注: a,肿物呈息肉样生长,可见细蒂,胆囊壁未明显增厚(HE,×8);b,肿物呈筛状及乳头状生长,细胞具有异型性(HE,×10);c,肿物呈筛状及实性生长,伴鳞状上皮化生(HE,×4);d,局部肿瘤细胞结构复杂,核异型性明显,可见核分裂象,呈高级别异型增生(HE,×20)。

    Figure  5.  Pathomorphological findings of gallbladder tumors

  • [1] FOLEY KG, LAHAYE MJ, THOENI RF, et al. Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE[J]. Eur Radiol, 2022, 32( 5): 3358- 3368. DOI: 10.1007/s00330-021-08384-w.
    [2] TASKIN OC, BASTURK O, REID MD, et al. Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions[J]. PLoS One, 2020, 15( 9): e0237979. DOI: 10.1371/journal.pone.0237979.
    [3] VALIBOUZE C, AMRANI M EL, TRUANT S, et al. The management of gallbladder polyps[J]. J Visc Surg, 2020, 157( 5): 410- 417. DOI: 10.1016/j.jviscsurg.2020.04.008.
    [4] HUANG JX, WANG Y, PANG Z. Research progress on risk factors and treatment strategies of malignant transformation of gallbladder polyps[J]. Int J Dig Dis, 2022, 42( 1): 13- 17. DOI: 10.3969/j.issn. 1673-7083.2022.01.004.

    黄军祥, 王允, 庞智. 胆囊息肉恶变危险因素及治疗策略的研究进展[J]. 国际消化病杂志, 2022, 42( 1): 13- 17. DOI: 10.3969/j.issn.1673-7083.2022.01.004.
    [5] ADSAY V, JANG KT, ROA JC, et al. Intracholecystic papillary-tubular neoplasms(ICPN) of the gallbladder(neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases[J]. Am J Surg Pathol, 2012, 36( 9): 1279- 1301. DOI: 10.1097/PAS.0b013e318262787c.
    [6] YU MH, KIM YJ, PARK HS, et al. Benign gallbladder diseases: Imaging techniques and tips for differentiating with malignant gallbladder diseases[J]. World J Gastroenterol, 2020, 26( 22): 2967- 2986. DOI: 10.3748/wjg.v26.i22.2967.
    [7] SHI Y, LIU HT. CT and MRI diagnosis of gallbladder adenoma[J]. Chin J CT and MRI, 2020, 18( 8): 97- 100. DOI: 10.3969/j.issn.1672-5131.2020.08.030.

    石岩, 刘海涛. 胆囊腺瘤的CT、MRI诊断[J]. 中国CT和MRI杂志, 2020, 18( 8): 97- 100. DOI: 10.3969/j.issn.1672-5131.2020.08.030.
    [8] NISHIYAMA Y, YAMAMOTO Y, FUKUNAGA K, et al. Dual-time-point 18F-FDG PET for the evaluation of gallbladder carcinoma[J]. J Nucl Med, 2006, 47( 4): 633- 638.
    [9] LEE J, YUN M, KIM KS, et al. Risk stratification of gallbladder polyps(1-2 cm) for surgical intervention with 18F-FDG PET/CT[J]. J Nucl Med, 2012, 53( 3): 353- 358. DOI: 10.2967/jnumed.111.093948.
    [10] PEDERSEN MR, DAM C, RAFAELSEN SR. Ultrasound follow-up for gallbladder polyps less than 6 mm may not be necessary[J]. Dan Med J, 2012, 59( 10): A4503.
    [11] METMAN M, OLTHOF PB, van der WAL J, et al. Clinical relevance of gallbladder polyps; is cholecystectomy always necessary?[J]. HPB(Oxford), 2020, 22( 4): 506- 510. DOI: 10.1016/j.hpb.2019.08.006.
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出版历程
  • 收稿日期:  2023-06-09
  • 录用日期:  2023-08-01
  • 出版日期:  2024-04-11
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