組織学的にtransitional portionを確認しえた肝嚢胞腺癌の1例 [in Japanese] A CASE OF BILIARY CYSTADENOCARCINOMA WITH TRASITIONAL PORTION IDENTIFIED BY HISTOLOGICAL EXAMINATION [in Japanese]
Access this Article
Search this Article
症例は63歳男性.主訴は上腹部痛.心窩部に弾性軟,表面平滑で圧痛を伴う腫瘤を触知.血液検査は腫瘍マーカーを含め異常なし.腹部USおよびCTで肝外側区域に辺縁が一部充実性の嚢胞性腫瘤を認めた.この充実性部分は造影CTでenhanceされ,血管造影では細血管の断裂と濃染を示した. ERCPでは胆管と嚢胞の交通はなかった.肝嚢胞腺癌と考え手術を施行.腫瘤の肝実質への浸潤はなく,外側区域切除で摘出可能であった.嚢胞内容は透明な粘液で,嚢胞内腔に向かって乳頭状の腫瘍が増殖し,その一部に出血が見られた.病理組織検査で乳頭状増殖部位の異型細胞と嚢胞壁の立方上皮との間にtransitional portionを認め,単純性肝嚢胞から癌化した肝嚢胞腺癌と考えた.
A 63-year-old man was seen at the hospital because of epigastralgia. Physical examination revealed an elastic soft and smooth mass with tenderness in the hypogastrium. Laboratory findings and tumor markers were in the normal range. Abdominal ultrasonogram and CT scan revealed a cystic and partially solid lesion in the lateral segment of the liver. In the solid portion, enhanced CT revealed an enhancement, and angiography demonstrated interruption of arterioles and accumulation of contrast material. The hepatic duct was not connected to the cyst on ERCP. With a diagnosis of biliary cystadenocarcinoma, an operation was performed. The lesion did not invade the hepatic parenchyma and could be removed by a lateral segmentectomy. The cyst contained clear mucinous fluid and a papillary projection with hemorrhage was found. Histopathologically, this lesion was considered to be biliary cystadenocarcinoma derived from a simple cyst, because a transitional portion was found between atypical cells in the papillary projection and cuboidal cells of the cyst wall.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 58(8), 1841-1845, 1997-08-25
Japan Surgical Association