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1例经结核聚合酶链反应阳性确诊的胆囊结核

[A case of gallbladder tuberculosis diagnosed by positive tuberculosis-polymerase chain reaction].

作者信息

Ryu Mi Jin, Jeon Tae Joo, Park Ji Young, Choi Yena, Baek Seung Suk, Sinn Dong Hyun, Oh Tae Hoon, Kim Jung Yeon

机构信息

Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Korea.

出版信息

Korean J Gastroenterol. 2014 Jan 25;63(1):51-5. doi: 10.4166/kjg.2014.63.1.51.

Abstract

Gallbladder tuberculosis is an extremely rare disease that is rarely reported in the literature. Arriving at the correct diagnosis of gallbladder tuberculosis is difficult, and it is usually made by histopathologic examination after cholecystectomy. However, due to the low sensitivity of acid-fast stain and culture result, diagnosing gallbladder tuberculosis is still demanding even after tissue acquisition. To overcome this problem, tuberculosis-polymerase chain reaction (TB-PCR) is performed on the resected specimen, which has high sensitivity and specificity. A 70-year-old female who had previously undergone total gastrectomy for advanced gastric cancer was admitted with right upper quadrant pain. Abdominal ultrasonography and computed tomography revealed acute cholecystitis without gallstones or sludge. She underwent cholecystectomy and the histopathologic finding of the specimen showed chronic active cholecystitis without gallstones or sludge. Because she was suspected to have pulmonary tuberculosis, TB-PCR was also performed on the resected gallbladder. TB-PCR showed positive reaction for Mycobacterium tuberculosis and we could diagnose it as gallbladder tuberculosis. Herein, we present a case of gallbladder tuberculosis diagnosed by TB-PCR from resected gallbladder.

摘要

胆囊结核是一种极为罕见的疾病,文献中鲜有报道。准确诊断胆囊结核颇具难度,通常需在胆囊切除术后通过组织病理学检查才能确诊。然而,由于抗酸染色和培养结果的敏感性较低,即便获取了组织,诊断胆囊结核仍颇具挑战。为克服这一问题,对切除标本进行结核聚合酶链反应(TB-PCR)检测,该方法具有较高的敏感性和特异性。一名70岁女性,既往因进展期胃癌接受了全胃切除术,此次因右上腹疼痛入院。腹部超声和计算机断层扫描显示为急性胆囊炎,无胆结石或胆泥。她接受了胆囊切除术,标本的组织病理学检查显示为无胆结石或胆泥的慢性活动性胆囊炎。由于怀疑她患有肺结核,对切除的胆囊也进行了TB-PCR检测。TB-PCR对结核分枝杆菌呈阳性反应,因此我们将其诊断为胆囊结核。在此,我们报告一例通过对切除胆囊进行TB-PCR检测而确诊的胆囊结核病例。

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