Kanaya Nobuhiko, Aoki Hideki, Yamasaki Rie, Morihiro Toshiaki, Takeuchi Hitoshi
Department of Surgery and Iwakuni Clinical Center, National Hospital Organization, Iwakuni, Yamaguchi 740-0041,
Acta Med Okayama. 2016 Oct;70(5):393-396. doi: 10.18926/AMO/54599.
We report a case of a granulocyte colony-stimulating factor (G-CSF)-producing gallbladder tumor associated with fever in a middle-aged female. Preoperative blood analysis showed leukocytosis with elevated levels of C-reactive protein and G-CSF. We resected the liver at S4a＋S5, with regional lymph node dissection and partial resection of the duodenum. Histology revealed undifferentiated carcinoma with spindle and giant cells and papillary adenocarcinoma. Immunohistochemistry revealed Stage IIIB G-CSF-producing gallbladder cancer. Postoperatively, leukocyte and serum G-CSF levels decreased to within normal limits. Adjuvant gemcitabine chemotherapy was administered for 16 months, and she has been recurrence-free for 48 months.
我们报告了一例中年女性胆囊肿瘤分泌粒细胞集落刺激因子（G-CSF）并伴有发热的病例。术前血液分析显示白细胞增多，C反应蛋白和G-CSF水平升高。我们切除了S4a＋S5段肝脏，进行了区域淋巴结清扫和十二指肠部分切除。组织学检查显示为伴有梭形和巨细胞的未分化癌以及乳头状腺癌。免疫组化显示为ⅢB期分泌G-CSF的胆囊癌。术后，白细胞和血清G-CSF水平降至正常范围。给予吉西他滨辅助化疗16个月，她已无复发48个月。
