Nagano Yasuhiko, Matsuo Kenichi, Gorai Katsuya, Sugimori Kazuya, Kunisaki Chikara, Ike Hideyuki, Tanaka Katsuaki, Imada Toshio, Shimada Hiroshi
Yokohama City University Medical Center, Gastroenterological Center, 232-0024 4-57 Urafunecho, Minami-ku, Yokohama City, Japan.
World J Gastroenterol. 2006 Feb 28;12(8):1321-3. doi: 10.3748/wjg.v12.i8.1321.
We present a case of a 72-year-old man with a common bile duct cancer, who was initially believed to have multiple liver metastases based on computed tomography findings, and in whom magnetic resonance cholangiography (MRC) revealed a diagnosis of bile duct hamartomas. At exploration for pancreaticoduodenectomy, liver palpation revealed disseminated nodules at the surface of the liver. These nodules showed gray-white nodular lesions of about 0.5 cm in diameter scattered on the surface of both liver lobes, which were looked like multiple liver metastases from bile duct cancer. Frozen section of the liver biopsy disclosed multiple bile ducts with slightly dilated lumens embedded in the collagenous stroma characteristics of multiple bile duct hamartomas (BDHs). Only two reports have described the MRC features of bile duct hamartomas. Of all imaging procedures, MRC provides the most relevant features for the imaging diagnosis of bile duct hamartomas.
我们报告一例72岁男性胆管癌患者,最初根据计算机断层扫描结果认为其有多发肝转移,而磁共振胆胰管造影(MRC)显示诊断为胆管错构瘤。在进行胰十二指肠切除术的探查中,肝脏触诊发现肝脏表面有散在结节。这些结节表现为直径约0.5 cm的灰白色结节性病变,散在于两叶肝脏表面,看似胆管癌的多发肝转移。肝脏活检冰冻切片显示多个胆管,管腔轻度扩张,包埋于具有多发胆管错构瘤(BDH)特征的胶原性基质中。仅有两篇报告描述了胆管错构瘤的MRC特征。在所有成像检查中,MRC为胆管错构瘤的成像诊断提供了最相关的特征。