Damianov D, Aleksandrova A, Vladimirov B, Dinkov L, Mikhova A
Khirurgiia (Sofiia). 1991;44(2):27-31.
Proceeding from a review of the literature and the personal observation of a case of tubulovillous adenoma of the large duodenal papilla, which had undergone malignant degeneration, the authors outline the diagnostic problems in this pathology. Since its clinical manifestations are not specific enough, it comes into consideration only after the possible more common diseases in the region of the right subcostal space have been ruled out. Preoperative diagnosis can be established mainly with fiber duodenoscopy. The demand from the pathologist is not only to give a histologic diagnosis, but to define the biologic nature of the tumor formation, since this predetermines the operative approach. It is sometimes difficult to give answer to the latter requirement even through and intraoperative express biopsy specimen examination.
基于对文献的回顾以及对一例发生恶性变的十二指肠大乳头绒毛管状腺瘤病例的个人观察，作者概述了这种病理学中的诊断问题。由于其临床表现不够特异，只有在排除了右肋缘下区域可能更常见的疾病之后才会考虑到它。术前诊断主要依靠纤维十二指肠镜检查来确立。病理学家的要求不仅是做出组织学诊断，还要确定肿瘤形成的生物学性质，因为这决定了手术方式。即使通过术中快速活检标本检查，有时也难以满足后一项要求。
