Imamura M, Miyashita T, Tani T, Naito A, Tobe T, Takahashi K
Am J Gastroenterol. 1984 Oct;79(10):790-5.
A 46-year-old woman visited our outpatient clinic complaining of dull right hypochondrial pain. Ultrasonography revealed four cysts in the right lobe of the liver. Arteriography and CT could not determine whether these cysts were benign or malignant. Because one of these cysts contained chocolate-colored fluid, amebic abscess was suspected, and the cyst was drained. No amebae were found in the cultured exudate, and fresh bleeding continued; therefore, laparotomy was performed. A tumor was present on the surface of the liver. Right lobectomy was performed. The resected specimen contained one nonepithelialized cyst which was invaded by surrounding cholangiocellular carcinoma and three epithelialized cysts. Preoperative diagnosis of this kind of cholangiocellular carcinoma seems to be very difficult. Recently cholangiocellular carcinoma associated with developmental cysts has been classified as a new entity different from cystadenocarcinoma. Cholangiocarcinoma, which belongs to this group, seems to deserve special attention.
一名46岁女性因右季肋部隐痛前来我院门诊就诊。超声检查发现肝脏右叶有4个囊肿。动脉造影和CT检查无法确定这些囊肿是良性还是恶性。由于其中一个囊肿含有巧克力色液体，怀疑为阿米巴脓肿，遂对该囊肿进行了引流。培养的渗出物中未发现阿米巴原虫，且持续有新鲜出血；因此，进行了剖腹手术。肝脏表面有一个肿瘤。实施了右叶切除术。切除标本中包含一个未上皮化的囊肿，其被周围的胆管细胞癌侵犯，以及三个上皮化的囊肿。术前诊断这种胆管细胞癌似乎非常困难。最近，与发育性囊肿相关的胆管细胞癌已被归类为一种不同于囊腺癌的新实体。属于该组的胆管癌似乎值得特别关注。
