Akatsu Tomotaka, Shimazu Motohide, Shinoda Masahiro, Kawachi Shigeyuki, Tanabe Minoru, Aiura Koichi, Ueda Masakazu, Kameyama Kaori, Sakamoto Michiie, Kitajima Masaki, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
Surg Today. 2007;37(10):905-9. doi: 10.1007/s00595-007-3485-9. Epub 2007 Sep 26.
We report a rare case of intrahepatic cholangiocarcinoma associated with old infestation of Schistosoma japonicum. The patient was a 76-year-old Japanese man who had lived his childhood in an endemic area of this parasite. He presented with jaundice and computed tomography showed a 4-cm, hypodense tumor in segment VIII of the liver. Microscopically, the resected mass was composed of well-differentiated adenocarcinoma cells. Fibrosis and inflammation were seen around the dilated peripheral portal veins embolized with dead S. japonicum eggs. Our search of the literature found only one other case of cholangiocarcinoma coincident with S. japonicum, suggesting that it is not a risk factor for cholangiocarcinoma, although the inflammation and fibrosis caused by the S. japonicum eggshells may predispose to carcinogenesis. However, there is no evidence supporting this hypothesis. More data are necessary to evaluate the differences in clinicopathological findings between cholangiocarcinoma concomitant with S. japonicum and the usual type of cholangiocarcinoma.
我们报告了一例罕见的肝内胆管癌合并日本血吸虫旧感染病例。患者为一名76岁的日本男性，其童年在这种寄生虫的流行地区度过。他因黄疸就诊，计算机断层扫描显示肝脏VIII段有一个4厘米的低密度肿瘤。显微镜下，切除的肿块由高分化腺癌细胞组成。在被死亡日本血吸虫卵栓塞的扩张外周门静脉周围可见纤维化和炎症。我们查阅文献发现仅有另一例胆管癌与日本血吸虫病同时存在的病例，这表明它并非胆管癌的危险因素，尽管日本血吸虫卵壳引起的炎症和纤维化可能易致癌变。然而，尚无证据支持这一假说。需要更多数据来评估合并日本血吸虫病的胆管癌与普通类型胆管癌在临床病理表现上的差异。
