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胃异位组织合并胆囊鳞状化生。

Gastric heterotopia together with squamous metaplasia in the gallbladder.

作者信息

Daud Mariana S, Salomão Frederico C, Salomão Eliane C, Salomão Bruno C

机构信息

Department of Surgical Pathology, Faculty of Medicine, Uberlandia Federal University Uberlandia, MG, Brazil.

出版信息

Acta Gastroenterol Latinoam. 2007 Sep;37(3):164-7.

Abstract

Heterotopic gastric mucosa in the gallbladder is extremely unusual. In this study, we aimed to report a case of gastric heterotopia together with squamous metaplasia in the gallbladder of a 47-year-old female patient who experienced an intensive abdominal pain. He was admitted to the hospital for clinical treatment without any improvement. Ultrasonography showed a stone located in the gallbladder neck and dilatation of intrahepatic bile ducts, both hepatic ducts and common hepatic duct. Laparoscopic cholecystectomy was performed. In the microscopical examination, the epithelium of the gallbladder revealed an unspecified chronic cholecystitis. Besides, at the level of the gallbladder body, a heterotopic gastric mucosa contain chief, parietal and mucosal cells with cystic glands and squamous metaplasia was found. Actually the patient is in long-time follow-up, asymptomatic. We also review 96 other reports of HGM in the gallbladder in the international medical literature from 1934. As heterotopic tissue may promote carcinogenesis of the gallbladder, close attention should be paid to any occurrence of such lesions in this anatomical region. It appears that laparoscopic cholecystectomy may be unavoidable for patients affected by heterotopic gastric mucosa at the present time and care must be taken when a diagnosis is made based on intraoperative frozen sections.

摘要

胆囊中的异位胃黏膜极为罕见。在本研究中,我们旨在报告一例47岁女性患者胆囊中胃异位伴鳞状化生的病例,该患者经历了剧烈腹痛。她入院接受临床治疗但无任何改善。超声检查显示胆囊颈部有结石,肝内胆管、左右肝管及肝总管均有扩张。遂行腹腔镜胆囊切除术。显微镜检查显示,胆囊上皮呈现未明确的慢性胆囊炎。此外,在胆囊体水平发现了异位胃黏膜,其中含有主细胞、壁细胞和黏液细胞,并伴有囊性腺体及鳞状化生。实际上,该患者正在接受长期随访,并无症状。我们还回顾了1934年以来国际医学文献中关于胆囊中异位胃黏膜的其他96篇报道。由于异位组织可能促进胆囊癌变,因此应密切关注该解剖区域此类病变的任何发生情况。目前,对于受异位胃黏膜影响的患者,腹腔镜胆囊切除术似乎是不可避免的,并且在基于术中冰冻切片进行诊断时必须谨慎。

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