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胆囊 Burkitt 淋巴瘤酷似胆囊癌:一例报告。

Gallbladder Burkitt's lymphoma mimicking gallbladder cancer: A case report.

机构信息

Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.

Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.

出版信息

World J Gastroenterol. 2022 Feb 14;28(6):675-682. doi: 10.3748/wjg.v28.i6.675.

Abstract

BACKGROUND

Malignant lymphoma is a rare form of gallbladder malignancy. Most of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas; however, Burkitt's lymphoma of the gallbladder is extremely rare, and only two previous reports are available in the literature. Herein, we report a rare case of Burkitt's lymphoma of the gallbladder mimicking gallbladder adenocarcinoma.

CASE SUMMARY

An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography (CT) performed for hypertension screening. His laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 receptor. Imaging examinations revealed two irregular and contrast-enhanced masses extending into the gallbladder lumen, but these did not infiltrate the serosa. Moreover, a periportal lymph node had enlarged to 30 mm. Based on these findings, we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis, which was treated using bile duct resection with gallbladder bed resection and periportal lymph node dissection. However, the patient was finally diagnosed as having Burkitt's lymphoma. Although the surgical margin was pathologically negative, recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after discharge. Thus, he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide, doxorubicin, vincristine, and prednisone.

CONCLUSION

Burkitt's lymphoma can occur in the gallbladder. Biopsy can be useful in cases with findings suggestive of gallbladder malignant lymphoma.

摘要

背景

恶性淋巴瘤是一种罕见的胆囊恶性肿瘤。这些恶性肿瘤大多为弥漫性大 B 细胞淋巴瘤或黏膜相关淋巴组织型淋巴瘤;然而,胆囊伯基特淋巴瘤极为罕见,文献中仅有两例报道。在此,我们报告一例罕见的胆囊伯基特淋巴瘤表现为胆囊腺癌。

病例摘要

一名 83 岁男性,因高血压筛查行计算机断层扫描(CT)检查时发现胆囊肿瘤和门静脉周围淋巴结肿大,无腹部不适症状。其实验室数据显示血清癌胚抗原和可溶性白细胞介素 2 受体略有升高。影像学检查显示两个不规则的、增强的肿块延伸至胆囊腔内,但未浸润浆膜。此外,门静脉周围淋巴结肿大至 30mm。根据这些发现,我们诊断患者患有胆囊腺癌伴淋巴结转移,行胆管切除术、胆囊床切除术和门静脉周围淋巴结清扫术治疗。然而,患者最终被诊断为患有伯基特淋巴瘤。尽管手术切缘病理学检查为阴性,但患者出院后不久,正电子发射断层扫描/CT 显示肝根治性切缘和胰十二指肠上淋巴结复发。因此,他被转介给血液科医生,并开始接受环磷酰胺、阿霉素、长春新碱和泼尼松减量治疗。

结论

胆囊可发生伯基特淋巴瘤。对于有胆囊恶性淋巴瘤表现的病例,活检可能有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e907/8900544/c544c2a976f0/WJG-28-675-g001.jpg

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