Adenomyomatosisに合併した早期胆嚢癌の1例

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  • A CASE OF ADENOMYOMATOSIS WITH AN EARLY CARCINOMA OF THE GALLBLADDER

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We experienced a case of bilocular gallbladder due to adenomyomatosis (ADM) with an early carcinoma of the gallbladder, which is relatively rare, in a 79-year-old woman. Abdominal ultrasonography and CT scanning revealed an uneven tumor of solid and cystic pattern with fine calcification in the fundus of the gallbladder. Contrast enhanced CT showed a 38×25mm tumor with a periphery only where slight accumulation of a contract material was seen. A carcinoma of the gallbladder associated with ADM of segmental type (type s) was suspected, and a cholecystectomy was performed. In the resected gallbladder, a great number of Rokitansky-Ashoff sinuses (RAS) of chronic cholecystitis in the fundus as well as thickening of the muscular layer were observed, indicating type s ADM. The adenocarcinoma in the fundus of the gallbladder was less than 1cm in size, and the carcinoma in mucosa was well differentiated adenocarcinoma with the invasion depth of mp and infiltrating into the muscular layer as well as extending in RAS. In addition, mucinous papillary adenoma like findings and atypical glandular epithelium were seen in the RAS glandular epithelium. A possibility that glandular epithelium had acquired various characters in the course of proliferation is suggested in this case.

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