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良性发现还是恶性肿瘤:腹腔镜胆囊切除术中发现 von Meyenburg 复合体。

Benign Finding or Malignancy: von Meyenburg Complexes Found during Laparoscopic Cholecystectomy.

机构信息

Department of Surgery, University of California Los Angeles, Los Angeles, CA.

出版信息

CRSLS. 2022 Dec 24;9(4). doi: 10.4293/CRSLS.2022.00080. eCollection 2022 Oct-Dec.

Abstract

Von Meyenburg complexes are benign bile duct hamartomas that arise as cystic nodules of the liver. Von Meyenburg complexes are often asymptomatic and thus typically discovered incidentally on imaging or autopsy. They can also be encountered at the time of surgery where they often appear as scattered white liver lesions concerning for malignancy. Here, we present a case in which white hepatic nodules were found incidentally during laparoscopic cholecystectomy in a 36 -year-old female. Pathologic analysis confirmed the diagnosis of von Meyenburg complexes. The operating surgeon proceeded with laparoscopic cholecystectomy without complication. We report this case to encourage awareness of this benign entity. The finding of scattered hepatic lesions found intra-operatively can create concern for metastatic neoplastic processes. An awareness of von Meyenburg complexes and their gross appearance can better guide surgeons' intraoperative decision-making when encountering these characteristic hepatic lesions.

摘要

Von Meyenburg 复合体是良性胆管错构瘤,作为肝脏的囊性结节出现。Von Meyenburg 复合体通常无症状,因此通常在影像学或尸检时偶然发现。在手术时也可能遇到,此时它们通常表现为散在的白色肝脏病变,令人担忧恶性肿瘤。在这里,我们介绍了一个病例,一名 36 岁女性在腹腔镜胆囊切除术中偶然发现白色肝结节。病理分析证实了 von Meyenburg 复合体的诊断。手术医生顺利完成了腹腔镜胆囊切除术,没有出现并发症。我们报告这个病例是为了引起对这个良性实体的认识。术中发现散在的肝病变会引起对转移性肿瘤过程的担忧。当遇到这些特征性的肝病变时,对 von Meyenburg 复合体及其大体外观的认识可以更好地指导外科医生的术中决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7613/9840201/f7294b0139d4/LS-JSLS220070F001.jpg

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