Huang Wan-Ting, Chuang Shih-Sung, Huang Chao-Cheng, Lu Chin-Li, Eng Hock-Liew
Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan, ROC.
N Z Med J. 2007 Mar 23;120(1251):U2470.
Primary non-Hodgkin lymphoma (NHL) of the gallbladder (GB-NHL) is exceedingly rare. We present our experience on a 78-year-old male with chief complaints of fever, chills, and epigastric dull pain. Abdominal computed tomography (CT) scan showed a few stones and focally thickened gallbladder wall. He received cholecystectomy under the preoperative diagnosis of acute cholecystitis with septic shock, while pathologic examination revealed cholelithiasis and diffuse large B-cell lymphoma without acute inflammation. Staging procedures revealed a stage IE tumour and the patient received adjuvant radiotherapy. Relapse as a large retroperitoneal mass was noted 32 months later and he passed away three years after initial diagnosis. A literature review revealed 20 cases of GB-NHL. We find that, including our current case, the median age is 63 years and 8 of 19 (42%) tumours are associated with gallstones. The mean and median survival of 15 patients with complete follow-up information is 75 and 36 months, respectively. Mucosa-associated lymphoid tissue (MALT) lymphoma seems to carry a longer survival than non-MALT lymphomas.
原发性胆囊非霍奇金淋巴瘤（GB-NHL）极为罕见。我们报告了一名78岁男性患者的病例，其主要症状为发热、寒战和上腹部钝痛。腹部计算机断层扫描（CT）显示有一些结石和胆囊壁局部增厚。他在术前诊断为急性胆囊炎伴感染性休克的情况下接受了胆囊切除术，而病理检查显示为胆结石和弥漫性大B细胞淋巴瘤，无急性炎症。分期检查显示为ⅠE期肿瘤，患者接受了辅助放疗。32个月后发现复发为巨大腹膜后肿块，患者在初次诊断三年后去世。文献回顾发现了20例GB-NHL病例。我们发现，包括我们目前的病例在内，中位年龄为63岁，19例肿瘤中有8例（42%）与胆结石有关。15例有完整随访信息的患者的平均生存期和中位生存期分别为75个月和36个月。黏膜相关淋巴组织（MALT）淋巴瘤的生存期似乎比非MALT淋巴瘤更长。
