Hwang Sang Youn, Kim Joon Suk, Jeong Ji Bong, Kim Ji Won, Kim Byeong Gwan, Lee Kook Lae, Ahn Young Joon, Chang Mee Soo
Departments of Internal Medicine, Seoul National University College of Medicine, SMG-SNU Borame Medical Center, Seoul, Korea.
Korean J Gastroenterol. 2010 Jun;55(6):404-9. doi: 10.4166/kjg.2010.55.6.404.
Xanthogranulomatous cholecystitis (XGC) is an unusual and destructive inflammatory process that is characterized by thickening of the gallbladder (GB) wall with a tendency to adhere to neighboring organs. XGC is often mistaken for GB carcinoma, and the frequency of the coexistence of these two lesions is approximately 10%. Therefore, in case of severe XGC, there is chance of either overlooking the carcinoma or other significant lesions. CA 19-9 is commonly measured in the serum of patients with hepatobiliary malignancies. Although CA 19-9 can be elevated in benign conditions such as cholestasis, pancreatitis, tuberculosis, thyroid disease etc., malignancy should be considered at first in setting of its significant and persistent elevation. We report a case of a 62-year-old man who showed continuously rising level of CA19-9 over 2000 U/mL after cholecystectomy for xanthogranulomatous cholecystitis and finally was diagnosed as cholangiocarcinoma by short-term follow up.
黄色肉芽肿性胆囊炎(XGC)是一种罕见的破坏性炎症过程,其特征为胆囊壁增厚并倾向于粘连邻近器官。XGC常被误诊为胆囊癌,这两种病变并存的发生率约为10%。因此,在严重XGC的情况下,有可能忽略癌症或其他重要病变。CA 19-9常用于检测肝胆恶性肿瘤患者的血清。虽然CA 19-9在胆汁淤积、胰腺炎、结核病、甲状腺疾病等良性疾病中也可能升高,但在其显著且持续升高时应首先考虑恶性肿瘤。我们报告一例62岁男性,因黄色肉芽肿性胆囊炎行胆囊切除术后CA19-9水平持续升高超过2000 U/mL,经短期随访最终诊断为胆管癌。