Sugawara Shuichiro, Hirai Ichiro, Watanabe Toshihiro, Tezuka Koji, Kimura Wataru
First Department of Surgery, Yamagata University Graduate School of Medical Science, 2-2-2 Iidanishi, Yamagatashi, Yamagata, 990-9585, Japan.
Clin J Gastroenterol. 2018 Oct;11(5):428-432. doi: 10.1007/s12328-018-0850-8. Epub 2018 Mar 13.
The patient was a 70-year-old woman in whom examination revealed a high level of carbohydrate antigen 19-9. Abdominal ultrasonography and computed tomography (CT) revealed a multilocular cystic lesion compressing the gallbladder. CT indicated the presence of a multilocular cystic tumor (67 × 68 × 72 mm) in contact with the right hepatic lobe. Intraoperative findings indicated that the cyst diameter was 8.5 × 6.0 cm, and the cyst was continuous with the gallbladder. The gallbladder was resected along with the cyst. The cyst was multilocular and originated from the cystic duct and gallbladder wall. The cyst wall contained cuboidal to columnar mucin-producing epithelial cells and ovarian-like stroma (OS). The final diagnosis was mucinous cystic neoplasm (MCN) of the gallbladder with low-grade dysplasia. In the 2010 WHO classification of tumors of the digestive system, MCN have been newly defined as a type of hepatobiliary tract epithelial neoplasms. MCN of the gallbladder with OS is extremely rare. Only three cases have been published in the literature. The presence of OS is necessary for diagnosis of MCN.
该患者为一名70岁女性，检查发现其碳水化合物抗原19-9水平较高。腹部超声和计算机断层扫描（CT）显示一个多房囊性病变压迫胆囊。CT显示存在一个与右肝叶相连的多房囊性肿瘤（67×68×72mm）。术中发现囊肿直径为8.5×6.0cm，且囊肿与胆囊相连。胆囊与囊肿一并切除。囊肿为多房性，起源于胆囊管和胆囊壁。囊肿壁包含立方形至柱状产生黏液的上皮细胞以及卵巢样间质（OS）。最终诊断为胆囊黏液性囊性肿瘤（MCN）伴低级别发育异常。在2010年世界卫生组织消化系统肿瘤分类中，MCN被重新定义为一种肝胆管上皮肿瘤类型。伴有OS的胆囊MCN极为罕见。文献中仅报道了3例。OS的存在是诊断MCN的必要条件。
