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胆囊中的异位胃黏膜:一例罕见病例及胆囊息肉的鉴别诊断

Heterotopic Gastric Mucosa in the Gallbladder: A Rare Case and Differential Diagnosis for a Gallbladder Polyp.

作者信息

Green Kesley, Jain Ekta, Al Diffalha Sameer

机构信息

Pathology, The University of Alabama at Birmingham, Birmingham, USA.

出版信息

Cureus. 2024 Oct 25;16(10):e72372. doi: 10.7759/cureus.72372. eCollection 2024 Oct.

Abstract

Heterotopia or ectopic tissue refers to the presence of normal tissue in an abnormal location, away from its typical anatomic site. While heterotopia is not uncommon, its occurrence in the gallbladder is quite rare, and even more unusual is the presence of gastric heterotopia within the gallbladder. This case report describes a 41-year-old female patient with oxyntic-type heterotopic gastric mucosa in the proximal body of the gallbladder. She initially visited the hospital for a routine follow-up for her degenerative joint disease when a gallbladder mass was incidentally discovered. Imaging revealed a circumferential, nodular wall thickening and enhancement of the proximal gallbladder body, along with mild diffusion restriction. Due to concern for primary gallbladder malignancy, a cholecystectomy was performed. Intraoperatively, the gallbladder appeared anatomically normal, with several adhesions and mild inflammation, prompting the omission of an intraoperative frozen section. Histopathologic analysis revealed oxyntic-type gastric mucosa within the gallbladder wall. Although this case of gastric heterotopia was benign, prolonged presence of gastric tissue in the gallbladder may lead to complications, such as ulceration, dysplasia, or even malignant transformation.

摘要

异位或异常组织是指正常组织出现在异常位置,远离其典型的解剖部位。虽然异位并不罕见,但它在胆囊中的发生相当罕见,而胆囊内出现胃异位则更为不寻常。本病例报告描述了一名41岁女性患者,其胆囊近端体部存在胃底型异位胃黏膜。她最初因退行性关节疾病到医院进行常规随访时,偶然发现胆囊肿物。影像学检查显示胆囊近端体部有环形、结节状壁增厚及强化,伴有轻度弥散受限。由于担心原发性胆囊恶性肿瘤,遂行胆囊切除术。术中,胆囊外观解剖结构正常,有几处粘连和轻度炎症,因此未进行术中冰冻切片检查。组织病理学分析显示胆囊壁内有胃底型胃黏膜。虽然此例胃异位为良性,但胆囊内胃组织的长期存在可能导致并发症,如溃疡、发育异常,甚至恶变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ea6/11586244/ea6862e97237/cureus-0016-00000072372-i01.jpg

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