Mendel R
Innere Abteilung I des Kreiskrankenhauses Lüdenscheid.
Dtsch Med Wochenschr. 1987 Dec 4;112(49):1906-7. doi: 10.1055/s-2008-1068352.
A 65-year-old man, in hospital for treatment for bladder carcinoma, was by chance found also to have a so far asymptomatic obstructive jaundice with hydrops of the gallbladder. Endoscopic retrograde cholangiography revealed, in addition to a papilla distorted by tumour, a clearly obstructed choledochal duct with dilated intrahepatic bile ducts, caused by a 2-3 cm prepapillary intraductal choledochus tumour, which in the biopsy specimen corresponded to papillomatous structures with occasional medium-grade epithelial dysplasias. The patients, who initially declined operation, was five weeks later re-admitted with the clinical picture of an acute abdomen. In view of the history the surgeon performed a partial duodenopancreatectomy despite the acute emergency. Histology revealed a highly differentiated adenocarcinoma within a villous adenoma of the choledochal duct near the papilla.
一名65岁男性因膀胱癌住院治疗，偶然发现还患有迄今为止无症状的梗阻性黄疸伴胆囊积水。内镜逆行胆管造影显示，除了被肿瘤扭曲的乳头外，还有一个明显梗阻的胆总管，肝内胆管扩张，这是由一个2 - 3厘米的乳头前胆管内肿瘤引起的，活检标本显示为乳头状结构，偶尔有中度上皮发育异常。该患者最初拒绝手术，五周后因急腹症临床表现再次入院。鉴于病史，外科医生尽管面临急性紧急情况，仍进行了部分十二指肠胰腺切除术。组织学检查显示，在乳头附近胆总管的绒毛状腺瘤内有高分化腺癌。
