Chen Y C, Chien R N, Chen M F, Ng K F, Tseng J H
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Chang Gung Med J. 2000 Sep;23(9):560-5.
A 63-year-old men suffered from fever, jaundice, and right upper quadrant pain for 1 week. Biliary stones with biliary tract infection were diagnosed. He was treated with parenteral antibiotics. However, abdominal ultrasonography showed multiple hyperechoic lesions in both lobes, and infiltrating hepatocellular carcinoma was suspected initially. Numerous hypervascular nodular-enhancing lesions were revealed by computed tomography. Magnetic resonance imaging further disclosed numerous tiny cystic lesions with peripheral enhancement. Exploratory laparotomy was performed for biliary calculi and probable underlying malignancy. Cholecystectomy, choledocholithotomy, and liver wedge biopsy were done. The pathology revealed bile duct hamartomas with microabscess formation. The past literature about biliary hamartomas is reviewed.
一名63岁男性发热、黄疸及右上腹疼痛1周。诊断为胆石症伴胆道感染。给予静脉抗生素治疗。然而,腹部超声显示两叶均有多个高回声病灶,最初怀疑为浸润性肝细胞癌。计算机断层扫描显示有许多高血管结节强化病灶。磁共振成像进一步发现许多周边强化的微小囊性病灶。因胆结石及可能存在的潜在恶性肿瘤行剖腹探查术。进行了胆囊切除术、胆总管切开取石术及肝楔形活检。病理显示为胆管错构瘤伴微脓肿形成。本文回顾了既往有关胆管错构瘤的文献。