Liu Lin-Na, Xu Hui-Xiong, Zheng Shu-Guang, Sun Li-Ping, Guo Le-Hang, Wu Jian
Lin-Na Liu, Hui-Xiong Xu, Shu-Guang Zheng, Li-Ping Sun, Le-Hang Guo, Jian Wu, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, Shanghai 200072, China.
World J Gastroenterol. 2014 Jun 7;20(21):6685-90. doi: 10.3748/wjg.v20.i21.6685.
Schwannomas occurring in the gallbladder are extremely rare. Preoperative diagnosis of gallbladder schwannomas appears to be very difficult because they are normally asymptomatic and are often found incidentally. Until now, only five cases have been reported in the literature. To our knowledge, the contrast-enhanced ultrasound (CEUS) features of gallbladder schwannomas have not been reported before in other studies. We treated a 55-year-old male patient with gallbladder schwannoma in China. He had no symptoms, and the lesion was incidentally found by conventional ultrasound (US) when performing a health examination. The patient had normal liver function; moreover, serum carcinoembryonic antigen and alpha-fetoprotein were within the normal ranges. The lesion showed no blood flow signals on color Doppler US, and the wall beneath the lesion was intact on CEUS. The lesion was believed to be a benign entity; in addition, gallbladder adenomyomatosis was suspected. A laparoscopic cholecystectomy was performed to remove the mass. Pathological examination revealed that the tumor was mainly composed of spindle-shaped cells; neither atypical cells nor signs of malignancy were found. Immunohistochemical staining showed a strong positive S-100 protein reaction. Vimentin and CD56 staining were also positive, whereas CD34 and CD117 were negative. Finally, the lesion was diagnosed as schwannoma. Herein, we report the case; the associated literature is also reviewed.
发生于胆囊的神经鞘瘤极为罕见。胆囊神经鞘瘤的术前诊断似乎非常困难，因为它们通常无症状，常为偶然发现。截至目前，文献中仅报道过5例。据我们所知，此前其他研究尚未报道过胆囊神经鞘瘤的超声造影（CEUS）特征。我们在中国治疗了一名患有胆囊神经鞘瘤的55岁男性患者。他没有症状，在进行健康检查时，该病变由常规超声（US）偶然发现。患者肝功能正常；此外，血清癌胚抗原和甲胎蛋白均在正常范围内。该病变在彩色多普勒超声上未显示血流信号，在CEUS上病变下方的胆囊壁完整。该病变被认为是良性病变；此外，怀疑有胆囊腺肌增生症。遂行腹腔镜胆囊切除术以切除肿块。病理检查显示肿瘤主要由梭形细胞组成；未发现非典型细胞或恶性征象。免疫组化染色显示S-100蛋白反应呈强阳性。波形蛋白和CD56染色也呈阳性，而CD34和CD117呈阴性。最终，该病变被诊断为神经鞘瘤。在此，我们报告该病例，并对相关文献进行综述。
