Takahashi Sho, Takada Kohichi, Kawano Yutaka, Miyanishi Koji, Ishiwatari Hirotoshi, Hayashi Tsuyoshi, Sagawa Tamotsu, Sato Tsutomu, Sato Yasushi, Takimoto Rishu, Kobune Masayoshi, Kuroiwa Ganji, Hirayama Michiaki, Tobioka Hirotoshi, Hirata Kouichi, Omatsu Mutsuko, Hasegawa Tadashi, Kato Junji
Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2010 Mar;107(3):461-9.
A 76-year-old man presented with fever of unknown origin. Diagnostic imaging showed a liver tumor measuring 3cm in maximum dimension. The tumor was subsequently resected, and histopathology showed a moderately differentiated adenocarcinoma. This showed a number of bile ductules with variable amounts of stroma, well circumscribed but not encapsulated, so the lesion was diagnosed as a cholangiocarcinoma. Within the tumor there was also a cholangiolocarcinoma-like lesion. In addition, cystically dilated ductules resembling bile duct hamartoma and bile duct adenoma adjacent to the tumor were found, but with no area of transition among them. In the Glisson's capsule around the tumor, there was also a bile duct hamartoma.
一名76岁男性因不明原因发热就诊。诊断性影像学检查显示肝脏有一个最大径为3cm的肿瘤。随后该肿瘤被切除，组织病理学显示为中分化腺癌。可见多个含有不同量间质的胆小管，边界清楚但无包膜，因此该病变被诊断为胆管癌。肿瘤内还存在一个胆管癌样病变。此外，在肿瘤附近发现了类似胆管错构瘤和胆管腺瘤的囊性扩张胆小管，但它们之间没有移行区域。在肿瘤周围的Glisson包膜内，也有一个胆管错构瘤。
