腺扁平上皮癌の組織型を呈した胆管細胞癌の1例 A SURGICAL CASE OF CHOLANGIOCELLULAR CARCINOMA PRESENTED HYSTOLOGIC TYPE OF ADENOSQUAMOUS CELL CARCINOMA

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腺扁平上皮癌の組織型を呈した胆管細胞癌の1例を経験した.症例は72歳の女性.右季肋部痛,発熱あり近医にて胆石症,胆管炎疑われ当院紹介入院となる.炎症所見と胆道系酵素の上昇あり,また腹部CT検査にて肝S4~S5にかけて肝外に突出した周囲enhanceされるlow density massをみとめた.注腸造影検査では,肝弯曲部付近の結腸に浸潤が疑われた.腹部超音波検査では,肝床部に内部不均一な腫瘤像を認め,肝外に突出し結腸浸潤をきたした胆管細胞癌と診断した.開腹所見では,肝S4, S5中心に腫瘤を認め胆嚢,結腸,十二指腸へ浸潤を認めた.手術は,肝S4a, S5切除,結腸,十二指腸部分切除術施行した.病理組織学検査にて肝内胆管原発の腺扁平上皮癌と診断された.術後2カ月で残肝再発しその1カ月後に死亡した.

This paper deals with a case of cholangiocellular carcinoma presented histologic type of adenosquamous cell carcinoma.<br>A 72-year-old woman complaining of right hypochondralgia and fever was admitted to the hospital with a suspicion of cholelithiasis or cholangitis by referral from other physician. On admission inflammatory findings and elevated biliary enzymes were noted. Abdominal CT scan showed a low density mass with enhanced periphery which protruded without the liver, ranging from S4 to S5 of the liver. On barium enema study, invasion into the colon in the vicinity of the hepatic flexure was suspected. Abdominal ultrasonic scan revealed a tumor shadow with heterogeneous internal part in the gallbladder bed. Cholangiocellular carcinoma with extrahepatic protrusion causing colonic invasion was thus diagnosed. At laparotomy, the principal lesion was present in the S4 and S5 of the liver and the gallbladder, colon, and duodenum were involved. Operative prosedures included hepatic resection for S4a and S5, colectomy, and partial duodenectomy. Histopathological diagnosis was adenosquamous cell carcinoma of the intrahepatic bile duct. The patient experienced metastasis of the hepatic remnant 2 months after the operation and one month later, she died.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 65(5), 1351-1355, 2004-05-25

    日本臨床外科学会

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各種コード

  • NII論文ID(NAID)
    10013165870
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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