Honda Munenori, Furuta Yoki, Naoe Hideaki, Sasaki Yutaka
Department of Gastroenterology and Hepatology, Kumamoto General Hospital, Yatsushiro, Japan.
Department of Gastroenterology and Hepatology, Kokuho Minamata Shiritsu Sogo Iryo Center, Minamata, Japan.
BMJ Case Rep. 2017 May 27;2017:bcr-2017-220161. doi: 10.1136/bcr-2017-220161.
Mucosa-associated lymphoid tissue (MALT) lymphoma is rarely observed in the gallbladder, and its diagnosis before surgery is difficult. This report describes a case of primary MALT lymphoma of the gallbladder in an 80-year-old man. Imaging studies revealed a protruding lesion on the inside of the gallbladder, which led us to diagnose gallbladder carcinoma prior to the patient undergoing extended cholecystectomy. Microscopic examination of the resected specimen of the gallbladder demonstrated lymphoid follicles with atypical lymphocytes and the formation of lymphoepithelial lesions. These findings led to a final pathological diagnosis of primary MALT lymphoma of the gallbladder. The patient has been free of recurrence for 39 months after the surgery. Although precise diagnosis before the surgery was difficult in this case, preoperative examinations revealed a submucosal tumour-like lesion. MALT lymphomas should be considered when imaging findings are atypical for gallbladder carcinoma.
黏膜相关淋巴组织（MALT）淋巴瘤在胆囊中很少见，术前诊断困难。本报告描述了一例80岁男性原发性胆囊MALT淋巴瘤病例。影像学检查显示胆囊内部有一个突出病变，这使我们在患者接受扩大胆囊切除术之前诊断为胆囊癌。对切除的胆囊标本进行显微镜检查发现有非典型淋巴细胞的淋巴滤泡和淋巴上皮病变形成。这些发现最终病理诊断为原发性胆囊MALT淋巴瘤。该患者术后39个月无复发。尽管本例术前难以精确诊断，但术前检查发现了一个黏膜下肿瘤样病变。当影像学表现不符合胆囊癌时，应考虑MALT淋巴瘤。
