Bilanović D, Boricić I, Zdravković D, Randjelović T, Stanisavljević N, Toković B
Department of Surgery, University Medical Center Bezanijska Kosa, Belgrade, Serbia.
Acta Chir Iugosl. 2008;55(4):99-101. doi: 10.2298/aci0804099b.
Granular cell tumors (GCT) are rare benign tumors. Less than 1% of GCTs involve the extrahepatic biliary tree. Most researches favour a Schwann cell origin. Patient, caucasion, female, 31-year-old presented with 4 month history of painless jaundice and pruritus. US and CT revealed dilatation of intrahepatic biliary tree and surgery was performed. Firm tumor mass was found above the conjunction of cystic duct and common hepatic duct (CHD) that caused obstruction and gallblader empyema. The patient underwent radical surgical procedure because Klatskin tumor was clinically suspected. Patohystology and immunohistochemistry confirmed granular cell tumor. Eight years after surgery the patient is wellbeing without symptoms. To our knowledge 69 cases of GCT of the extrahepatic biliary tree have been reported and none of the acute acalculous cholecystitis case acompanied by GCT of CHD. Granular cell tumors are rarely diagnosed preoperatively. Wide resection offers the best chance for cure.
颗粒细胞瘤（GCT）是一种罕见的良性肿瘤。不到1%的颗粒细胞瘤累及肝外胆管树。大多数研究支持其起源于施万细胞。患者为31岁白种女性，有4个月无痛性黄疸和瘙痒病史。超声和CT显示肝内胆管扩张，遂行手术。在胆囊管与肝总管（CHD）交界处上方发现质地坚硬的肿瘤肿块，导致梗阻和胆囊积脓。由于临床怀疑为肝门部肿瘤，患者接受了根治性手术。病理组织学和免疫组织化学证实为颗粒细胞瘤。手术后八年，患者状况良好，无任何症状。据我们所知，已报道69例肝外胆管颗粒细胞瘤病例，且无一例急性非结石性胆囊炎病例合并肝总管颗粒细胞瘤。颗粒细胞瘤术前很少被诊断出来。广泛切除提供了最佳的治愈机会。
