Kameyama Takeharu, Yasunaga Yuichi, Kizu Takashi, Miyoshi Rika, Watanabe Chie, Yamamoto Shunsuke, Matsumoto Yumi, Inui Yoshiaki, Hayashi Nobuyasu, Fukuchi Nariaki, Hasuike Yasunori, Koshino Tsukasa, Izumiyama Kazutaka, Kohro Takashi, Nishikawa Masahiro
Department of Internal Medicine, Hyogo Prefectural Nishinomiya Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2006 Jun;103(6):636-42.
A 63-year-old man visited our hospital complaining of brown urine. A physical examination showed jaundice of the skin and conjunctiva bulbar. Blood tests showed elevated serum levels of bilirubin and hepatobiliary enzymes. A type 2-like mass lesion was found near the papilla of Vater during the endoscopic retrograde cholangiopancreatography and was histologically proven to be a well-differentiated adenocarcinoma. A diagnosis of obstructive jaundice due to primary duodenal cancer arising near the papilla of Vater was made. After the jaundice was decreased by endoscopic biliary stenting, a pancreatoduodenectomy was performed. A histopathological examination of the resected specimen concerning the location and manner of invasion of cancer cells revealed that the cancer arose from the duodenal mucosa near the papilla of Vater.
一名63岁男性因茶色尿前来我院就诊。体格检查发现皮肤和球结膜黄疸。血液检查显示血清胆红素和肝胆酶水平升高。在内镜逆行胰胆管造影术中,在 Vater 乳头附近发现一个2型样肿块病变,组织学证实为高分化腺癌。诊断为 Vater 乳头附近原发性十二指肠癌所致梗阻性黄疸。在内镜下胆管支架置入使黄疸减轻后,进行了胰十二指肠切除术。对切除标本进行的关于癌细胞浸润位置和方式的组织病理学检查显示,癌症起源于 Vater 乳头附近的十二指肠黏膜。