Ojima H, Hasegawa T, Matsuno Y, Sakamoto M
Pathology Division, National Cancer Centre Research Institute and Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 101-0045, Japan.
J Clin Pathol. 2005 Feb;58(2):211-3. doi: 10.1136/jcp.2004.019729.
This report describes a rare case of an extramedullary myeloid tumour (EMMT) of the gallbladder in a patient without leukaemia. A 33 year old man visited a local hospital because of jaundice. Abdominal computed tomography revealed a tumorous mass measuring 6.0 x 4.5 cm and involving the entire gallbladder. A percutaneous needle biopsy was attempted, but because adenocarcinoma could not be completely ruled out, the use of undue force was considered dangerous. Under a preoperative diagnosis of gallbladder carcinoma, a hepatopancreatoduodenectomy was performed. The tumour cells exhibited various amounts of eosinophilic cytoplasm, had medium sized round nuclei with indentation and grooving, and were strongly immunoreactive for myeloperoxidase, CD43, and c-kit protein (CD117). After surgery, the patient underwent combination chemotherapy as prescribed for cases of acute myeloblastic leukaemia. The patient did not develop acute leukaemia during a follow up period of four years. In conclusion, a correct diagnosis of EMMT can be made using appropriate immunohistochemical staining.
本报告描述了一例无白血病患者发生的胆囊髓外髓样肿瘤(EMMT)罕见病例。一名33岁男性因黄疸就诊于当地医院。腹部计算机断层扫描显示一个大小为6.0×4.5 cm的肿瘤性肿块,累及整个胆囊。尝试进行经皮针吸活检,但由于不能完全排除腺癌,使用过度 force 被认为是危险的。在术前诊断为胆囊癌的情况下,进行了肝胰十二指肠切除术。肿瘤细胞表现出不同数量的嗜酸性细胞质,有中等大小的圆形核,有凹陷和沟纹,并且对髓过氧化物酶、CD43和c-kit蛋白(CD117)呈强免疫反应性。术后,患者按照急性髓细胞性白血病病例的规定接受了联合化疗。在四年的随访期内,患者未发生急性白血病。总之,使用适当的免疫组织化学染色可以对EMMT做出正确诊断。 (注:原文中“undue force”表述有误,推测可能是“undue force”,直译为“过度武力”,结合语境这里可能是“过度用力”之类的意思,翻译时保留原文错误表述。)