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胆囊原发性类癌肿瘤:一例病例报告并文献复习。

Primary carcinoid tumor of the gallbladder: a case report and brief review of the literature.

机构信息

Department of Hepatobiliary Surgery, The PLA 309 Hospital, Beijing, PR China.

出版信息

World J Surg Oncol. 2010 Feb 23;8:12. doi: 10.1186/1477-7819-8-12.

Abstract

BACKGROUND

Primary carcinoid tumor of the gallbladder is rare and comprises less than 1% of all carcinoid tumors. Preoperative diagnosis of carcinoid tumor of the gallbladder is difficult. The imageology findings are similar to those in other gallbladder cancers.

CASE PRESENTATION

A 46-year-old woman was hospitalized with a preoperative diagnosis of gallbladder carcinoma, The patient was referred for surgical opinion and laparotomy was subsequently performed. A 4 x 5 cm mass was found within the gallbladder, located on the free surface of the body and fundus of the gallbladder. Neither metastases nor direct invasion to the liver was found. The entire mass and gallbladder were excised and intact. Histologically, the tumor consisted of small oval cells with round-to-oval neclei and tumor cells formed small nodular, trabeculare and acinar structures. The tumor showed moderate pleomorphism with scattered mitotic figures, but no definite evidence of vascular permeation, perineural invasion or lymphatic permeation was seen. The tumor cells invaded the mucosa extensively, and some penetrated the muscular layer but not through the serosa of the gallbladder into the liver. Immunohistochemical studies revealed strong positive reaction for chromogranin A and NSE. This lesion was proved to be a primary carcinoid tumor of the gallbladder. A brief review of literature, clinical feature, pathology and treatment of this rare disease was discussed.

CONCLUSION

Primary carcinoid tumor of the gallbladder is uncommon. The definite diagnosis is often made on histopathological results after surgery.

摘要

背景

原发性胆囊类癌罕见,占所有类癌肿瘤的比例不足 1%。术前诊断胆囊类癌较为困难。影像学表现与其他胆囊癌相似。

病例介绍

一名 46 岁女性因术前诊断为胆囊癌住院。患者被转至外科并随后进行了剖腹手术。在胆囊内发现一个 4x5cm 的肿块,位于胆囊体和底部的游离面。未发现转移或直接侵犯肝脏。整个肿块和胆囊均被完整切除。组织学上,肿瘤由小的椭圆形细胞组成,核呈圆形至椭圆形,肿瘤细胞形成小结节状、小梁状和腺样结构。肿瘤有中度异型性,有散在的有丝分裂象,但无明确的血管浸润、神经周围浸润或淋巴管浸润的证据。肿瘤细胞广泛侵犯黏膜,部分穿透肌层但未穿透胆囊浆膜进入肝脏。免疫组织化学研究显示嗜铬粒蛋白 A 和 NSE 强阳性反应。该病变被证实为原发性胆囊类癌。本文简要复习了这种罕见疾病的临床特征、病理学和治疗方法。

结论

原发性胆囊类癌并不常见。明确诊断通常需要术后的组织病理学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5593/2834672/d8b42484c7b8/1477-7819-8-12-1.jpg

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