Kawate Susumu, Ohwada Susumu, Ikota Hayato, Hamada Kunihiro, Kashiwabara Kenji, Morishita Yasuo
Department of Surgery, Gunma University Graduate School of Medicine, 3-39-22, Maebashi, Gunma 371-8511, Japan.
World J Gastroenterol. 2006 Jul 21;12(27):4428-30. doi: 10.3748/wjg.v12.i27.4428.
This article reports the case of a 34-year-old woman with xanthogranulomatous cholangitis who developed obstructive jaundice. Microscopically, the bile duct was surrounded and narrowed by a xanthogranulomatous lesion, but no xanthogranulomatous cholecystitis was seen. Although percutaneous cholangiograms done via the transhepatic biliary drainage showed smooth narrowing of the upper to middle bile duct, the cytology of bile was diagnosed as class V adenocarcinoma. Therefore, right extended hepatectomy and extrahepatic bile duct resection were performed. The differentiation of benign and malignant strictures at the hepatic hilum is often difficult. Xanthogranulomatous cholangitis is one possible diagnosis of a bile duct stricture. Precise review of all the preoperative information is required to make a correct diagnosis.
本文报道了一例34岁患有黄色肉芽肿性胆管炎并出现梗阻性黄疸的女性病例。显微镜下,胆管被黄色肉芽肿性病变包绕并变窄,但未见黄色肉芽肿性胆囊炎。尽管经皮经肝胆道引流进行的经皮胆管造影显示肝门中上段胆管呈光滑狭窄,但胆汁细胞学检查诊断为V级腺癌。因此,实施了右半肝扩大切除术及肝外胆管切除术。肝门处良恶性狭窄的鉴别往往很困难。黄色肉芽肿性胆管炎是胆管狭窄的一种可能诊断。为做出正确诊断,需要对所有术前信息进行精确评估。