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[一例术前诊断困难的胆囊囊性错构瘤病例]

[A Case of Cystic Biliary Hamartoma with a Difficult Preoperative Diagnosis].

作者信息

Ohashi Tomofumi, Sakai Kenji, Yoshida Masayuki, Hara Shuichiro, Takayama Keita, Yoneda Kazuhiro, Osawa Hideki, Ide Yoshihito, Noro Hiroshi, Hirao Takafumi, Iwasaki Teruo, Hatanaka Nobutaka, Yamasaki Yoshio

机构信息

Dept. of Surgery, Japan Community Healthcare Organization(JCHO) Osaka Hospital.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):2345-2347.

Abstract

Intrahepatic bile duct dilatation was detected in a 63-year-old man based on abdominal ultrasonography. The computed tomography and magnetic resonance imaging scans showed an intrahepatic cystic lesion in the hilar bile duct that led to intrahepatic bile duct dilatation. As a result, intraductal papillary neoplasm of the bile duct(IPNB)was suspected. Moreover, the intrahepatic bile duct dilatation was confirmed by endoscopic retrograde cholangiopancreatography(ERCP). Biliary and brushing cytology indicated that the cystic lesion was class Ⅱ and class Ⅲ, respectively. Radiological imaging test did not rule out the possibility of a malignant lesion. Hence, a radical left hepatectomy was performed. Histopathological examination of the resected specimen indicated that it was a non-malignant cystic biliary hamartoma. Cystic biliary hamartoma or the von Meyenburg complex is a relatively rare disease. Although this disease is categorized as benign, differential diagnosis between benign and malignant forms is difficult, and this is an important clinical issue.

摘要

通过腹部超声检查,在一名63岁男性中检测到肝内胆管扩张。计算机断层扫描和磁共振成像扫描显示肝门部胆管有一个肝内囊性病变,导致肝内胆管扩张。因此,怀疑为胆管内乳头状肿瘤(IPNB)。此外,经内镜逆行胰胆管造影(ERCP)证实了肝内胆管扩张。胆汁和刷检细胞学检查分别显示囊性病变为Ⅱ级和Ⅲ级。影像学检查未排除恶性病变的可能性。因此,实施了根治性左肝切除术。切除标本的组织病理学检查表明,这是一个非恶性的囊性胆管错构瘤。囊性胆管错构瘤或梅耶堡复合体是一种相对罕见的疾病。虽然这种疾病被归类为良性,但良性和恶性形式之间的鉴别诊断很困难,这是一个重要的临床问题。

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