Ooe Yuka, Tsukada Tomoya, Yamasaki Yuki, Kaji Masahide, Shimizu Kouichi
Dept. of Surgery, Toyama Prefectural Central Hospital.
Gan To Kagaku Ryoho. 2019 Nov;46(11):1765-1769.
A 60s woman was found to have wall thickening of the gastric body and gallbladder in the follow-up CT scan after surgery for cervical carcinoma. An endoscopic examination revealed a type 3 tumor, located in the lesser curvature of the middle stomach. Abdominal CT showed lymphadenopathy at the lesser curvature. An enhanced thickened wall was also noted in the fundus of the gallbladder. FDG-PET/CT showed negative uptake in the gallbladder lesion. Distal gastrectomy and cholecystectomy were performed under the preoperative diagnosis of gastric cancer and adenomyomatosis. Histopathologically, the gastric lesion was a poorly differentiated adenocarcinoma, SE, ly1c, v1b. Moreover, the gallbladder lesion was a poorly differentiated adenocarcinoma proliferating mainly in the muscularis propria and subserosa, which had similar histological features as those in the adenocarcinoma part of gastric cancer. From these findings, the patient was diagnosed with gallbladder metastasis from gastric cancer. Gastric cancer rarely metastasizes to the gallbladder, and only 16 cases have been reported in Japan. We present the clinicopathological features with a review of the literature.
一名60多岁的女性在宫颈癌手术后的随访CT扫描中发现胃体和胆囊壁增厚。内镜检查发现一个3型肿瘤，位于胃中部小弯处。腹部CT显示小弯处有淋巴结肿大。胆囊底部也可见强化增厚的壁。FDG-PET/CT显示胆囊病变处无摄取。在术前诊断为胃癌和腺肌瘤病的情况下，进行了远端胃切除术和胆囊切除术。组织病理学检查显示，胃部病变为低分化腺癌，SE，ly1c，v1b。此外，胆囊病变为主要在固有肌层和浆膜下层增殖的低分化腺癌，其组织学特征与胃癌腺癌部分相似。根据这些发现，该患者被诊断为胃癌胆囊转移。胃癌很少转移至胆囊，在日本仅报道过16例。我们结合文献复习介绍其临床病理特征。
