Koya Yudai, Hanada Shun, Murakami Tomoyuki, Miyagawa Koichiro, Maruno Yuki, Yamaguchi Koki, Mukawa Shinji, Harada Masaru
Department of Gastroenterology, Kyushu Rosai Hospital Moji Medical Center, Japan.
The Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2025 May 1;64(9):1321-1326. doi: 10.2169/internalmedicine.4357-24. Epub 2024 Sep 18.
A 78-year-old man was diagnosed with advanced poorly differentiated gastric adenocarcinoma, presenting with jaundice and diffuse thickening of the extrahepatic bile duct. No obstructive biliary sites or liver masses were observed. The serum concentrations of proteins induced by the absence of vitamin K or antagonist-II were markedly high. Samples of the extrahepatic bile duct and liver were obtained by endoscopic examination. The patient was diagnosed with lymphangiosis carcinomatosa of the liver and extrahepatic bile duct but died 28 days after hospitalization. As the disease progresses rapidly with uncharacteristic imaging findings, biopsy samples should be obtained early using several diagnostic tools.
一名78岁男性被诊断为晚期低分化胃腺癌，伴有黄疸和肝外胆管弥漫性增厚。未观察到胆管梗阻部位或肝脏肿块。维生素K缺乏或拮抗剂-II诱导的蛋白血清浓度显著升高。通过内镜检查获取了肝外胆管和肝脏样本。该患者被诊断为肝脏和肝外胆管淋巴管癌，但住院28天后死亡。由于该疾病进展迅速且影像学表现不典型，应尽早使用多种诊断工具获取活检样本。
