Kaiho T, Tanaka T, Tsuchiya S, Miura M, Saigusa N, Yanagisawa S, Takeuchi O, Kitakata Y, Saito H, Shimizu A, Miyazaki M
Department of Surgery, Kimitsu Chuo Hospital, Chiba, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2189-95.
A 58 year-old man was admitted to Kimitsu Chuo Hospital complaining of epigastralgia. Abdominal ultrasound and computed tomography revealed a polypoid lesion at the neck of the gallbladder. Given the pre-operative diagnosis of gallbladder carcinoma, we resected the gallbladder along with the extrahepatic bile duct. There was a papillary tumor (25 x 16 mm) at the neck of the gallbladder. Histopathological examinations showed a subserosal nodular proliferation of uniform small tumor cells. Grimelius staining was slightly positive and Fontana-Masson staining was negative. Most of the tumor cells stained positively for chromogranin A and neuron-specific enolase (NSE), and some of the tumor cells were positive for pancreatic polypeptide. The presence of neurosecretory intracytoplasmic granules was proven ultrastructurally. It was diagnosed as a classical carcinoid tumor of the gallbladder. We reviewed the Japanese reported cases and discussed the difference in clinicopathological findings between classical and atypical carcinoid tumors of the gallbladder. Classical carcinoids of the gallbladder have neither a metastatic nor invasive character, and an extremely favorable prognosis compared with atypical carcinoids. The difference in character between classical and atypical carcinoids of the gallbladder is thought to be derived from their histogenetic origin.
一名58岁男性因上腹部疼痛入住君津中央医院。腹部超声和计算机断层扫描显示胆囊颈部有一个息肉样病变。鉴于术前诊断为胆囊癌，我们切除了胆囊及肝外胆管。胆囊颈部有一个乳头状肿瘤（25×16毫米）。组织病理学检查显示浆膜下有均匀的小肿瘤细胞结节状增生。嗜银染色呈弱阳性，Fontana-Masson染色呈阴性。大多数肿瘤细胞嗜铬粒蛋白A和神经元特异性烯醇化酶（NSE）染色呈阳性，一些肿瘤细胞胰多肽染色呈阳性。超微结构证实存在神经分泌性胞浆颗粒。诊断为胆囊经典型类癌肿瘤。我们回顾了日本报道的病例，并讨论了胆囊经典型和非典型类癌肿瘤临床病理表现的差异。胆囊经典型类癌既无转移也无侵袭性，与非典型类癌相比预后极佳。胆囊经典型和非典型类癌在特征上的差异被认为源于它们的组织发生起源。
