Gao Fei, Zhao Haichao, Chen Xidong, Dong Xiushan, Liu Tao, Fu Xifeng
Shanxi Academy of Medical Sciences Shanxi Dayi Hospital, Longcheng Street 99, Taiyuan, Shanxi, 030032, China.
Graduate School of Shanxi Medical University, Xinjian South Road 56, Taiyuan, Shanxi, 030032, China.
Int J Surg Case Rep. 2019;61:218-221. doi: 10.1016/j.ijscr.2019.07.064. Epub 2019 Jul 25.
Extrahepatic biliary non-Hodgkin's lymphoma (EBNHL) is rare, with a prevalence of 0.6% of malignant biliary tumors. Primary biliary non-Hodgkin's lymphoma accounts for 0.4% of extranodal non-Hodgkin's lymphoma (NHL), accounting for approximately 0.016% of all NHL cases. The patient presented with typical bile duct disappearance syndrome. The late performance is a bloodthirsty syndrome.
This patient was admitted to the hospital with "intermittent fever, abdominal pain for 19 days". The relevant laboratory tests showed severe infection. The patients were treated according to abdominal infection, and then laparoscopic cholecystectomy was performed. After the operation, the patient's condition did not relieve and further deteriorated. Postoperative patient performance was not based on preoperative estimates, and surgery did not achieve the desired results. Postoperative pathological diagnosis confirmed gallbladder non-Hodgkin's lymphoma. The patient eventually died.
Non-calculus inflammation occurs more frequently in the gallbladder. Non-calculus infections are generally caused by bile stasis and ischemia, resulting in bacterial reproduction and reduced blood supply, and gangrene and perforation of the gallbladder are more likely to occur. This patient is also diagnosed and treated according to this idea. The development after surgery completely exceeded our expectations. Gallbladder non-Hodgkin's lymphoma is very rare, and this case also includes hemophagocytic syndrome and bile duct disappearance syndrome, which is rare.
Malignant lymphoma of the extrahepatic biliary system is extremely rare, and its clinical manifestations are easily misdiagnosed. At the same time, non-calculous cholecystitis with fever, jaundice and hepatosplenomegaly should be considered.
肝外胆管非霍奇金淋巴瘤(EBNHL)较为罕见,占恶性胆管肿瘤的0.6%。原发性胆管非霍奇金淋巴瘤占结外非霍奇金淋巴瘤(NHL)的0.4%,约占所有NHL病例的0.016%。该患者表现为典型的胆管消失综合征。晚期表现为噬血细胞综合征。
该患者因“间断发热、腹痛19天”入院。相关实验室检查显示严重感染。患者按腹部感染进行治疗,随后行腹腔镜胆囊切除术。术后患者病情未缓解且进一步恶化。术后患者表现与术前评估不符,手术未达到预期效果。术后病理诊断确诊为胆囊非霍奇金淋巴瘤。患者最终死亡。
非结石性胆囊炎在胆囊中更常见。非结石性感染通常由胆汁淤积和缺血引起,导致细菌繁殖和血供减少,胆囊更易发生坏疽和穿孔。该患者也是按此思路进行诊断和治疗的。术后的发展完全超出了我们的预期。胆囊非霍奇金淋巴瘤非常罕见,该病例还合并噬血细胞综合征和胆管消失综合征,更是罕见。
肝外胆管系统恶性淋巴瘤极为罕见,其临床表现易被误诊。同时,对于伴有发热、黄疸和肝脾肿大的非结石性胆囊炎应予以考虑。