Terada T, Kurumaya H, Nakanuma Y
Second Department of Pathology, Kanazawa University School of Medicine, Japan.
Am J Gastroenterol. 1989 Nov;84(11):1434-6.
A rare autopsy case of intrahepatic cholesterol stones associated with peripheral intrahepatic cholangiocellular carcinoma is presented. The patient, a 60-yr-old man, was diagnosed as having peritoneal dissemination of adenocarcinoma, and died of respiratory failure 4 months later. At autopsy, intrahepatic cholangiocellular carcinoma was found at the left lateral segment of the liver. The cancer was extensively disseminated to the peritoneal cavity. In addition, the liver harbored a cholesterol stone (1.0 cm in diameter) impacted in the right peripheral bile duct, as well as tiny cholesterol stones (0.1-0.2 cm in diameter) scattered in the intrahepatic peripheral bile ducts. A few tiny cholesterol stones were also present in the cancerous bile ducts. Although the causal relationship between the intrahepatic cholesterol stones and cholangiocellular carcinoma remains speculative, clinicians should be aware of this association.
本文报告了一例罕见的肝内胆固醇结石合并肝内周围型胆管细胞癌的尸检病例。患者为一名60岁男性,被诊断为腺癌腹膜播散,4个月后死于呼吸衰竭。尸检时,在肝脏左外侧段发现肝内胆管细胞癌。肿瘤广泛播散至腹腔。此外,肝脏右外周胆管有一枚直径1.0 cm的胆固醇结石嵌顿,肝内外周胆管散在直径0.1 - 0.2 cm的微小胆固醇结石。癌性胆管内也有少量微小胆固醇结石。尽管肝内胆固醇结石与胆管细胞癌之间的因果关系仍属推测,但临床医生应注意到这种关联。