切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 475 -478. doi: 10.3877/cma.j.issn.1674-0785.2020.06.015

所属专题: 经典病例 文献

病例报告

肝内胆管乳头状肿瘤一例
邱雷雨1,(), 郑军2, 朱铁明2, 郦秀芳3   
  1. 1. 311800 浙江诸暨,绍兴文理学院附属诸暨市人民医院放射科
    2. 311800 浙江诸暨,绍兴文理学院附属诸暨市人民医院肝胆外科
    3. 311800 浙江诸暨,绍兴文理学院附属诸暨市人民医院病理科
  • 收稿日期:2020-02-27 出版日期:2020-06-15
  • 通信作者: 邱雷雨

A case of intraductal papillary neoplasm of the bile duct

Leiyu Qiu1(), Jun Zheng2, Tieming Zhu2   

  • Received:2020-02-27 Published:2020-06-15
  • Corresponding author: Leiyu Qiu
引用本文:

邱雷雨, 郑军, 朱铁明, 郦秀芳. 肝内胆管乳头状肿瘤一例[J]. 中华临床医师杂志(电子版), 2020, 14(06): 475-478.

Leiyu Qiu, Jun Zheng, Tieming Zhu. A case of intraductal papillary neoplasm of the bile duct[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(06): 475-478.

图1 CT轴位平扫图 图a为CT平扫示左肝Ⅱ段4.2 cm×3.9 cm团块状界清混杂密度影(箭);图b、c示增强扫描动脉期及门静脉期病灶内实质性部分呈乳头结节状(箭),表现为渐进性强化
图2 MRI影像图 图a示MRI病灶位于左肝Ⅱ段,轮廓光整,T1WI呈界清等低信号。图b为T2WI示病灶主体呈明显高信号,其内实质部分呈乳头结节略高信号。图c、d为增强扫描动脉期及门静脉期病灶内实质性部分呈渐进性强化(箭)
图3 磁共振胰胆管成像示病灶与胆管相通,病灶上下游胆管均有不同程度扩张改变
图4 肝内胆管乳头状瘤切除的大体标本 肿块位于扩张左肝内胆管内,呈多发乳头结节状,质软
图5 肝内胆管乳头状瘤病理图(HE染色,×100)镜下显示肿瘤细胞呈乳头状排列,有真性纤维血管束;细胞呈柱状或多边形,核呈圆形或卵圆形,染色质较稀疏,可见小核仁,胞浆较丰富,细胞异型,可见病理性核分裂
图6 术后1个月T管造影示右肝管及胆总管通畅
图7 术后3个月CT复查呈左肝术后无明显转移及复发征象
1
Kim JR, Lee KB, Kwon W, et al. Comparison of the Clinicopathologic Characteristics of Intraductal PapillaryNeoplasm of the Bile Duct according to Morphological and Anatomical Classifications [J]. J Korean Med Sci, 2018, 33(42): e266.
2
Park HJ, Kim SY, Kim HJ, et al. Intraductal Papillary Neoplasm of the Bile Duct: Clinical, Imaging, and Pathologic Features [J]. AJR Am J Roentgenol, 2018, 11(1): 67-75.
3
Wu X, Li B, Zheng C, et al. Intraductal papillary neoplasm of the bile duct: a single-center retrospective study [J]. J Int Med Res, 2018, 46(10): 4258-4268.
4
Yaohong Tan, Clara Milikowski, Yanelba Toribio, et al. Intraductal papillary neoplasm of the bile ducts: A case report and literature review [J]. World J Gastroenterol, 2015, 21(43): 12498-12504.
5
Nam NH, Taura K, Kanai M, et al. Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs: A case report [J]. World J Gastroenterol, 2020, 26(3): 366-374.
6
Yumiko Kageyama, Ryuzo Yamaguchi, Shinya Watanabe, et al. Intraductal papillary neoplasm of the bile duct with rapidly progressive multicentric recurrence: A case report [J]. Int J Surg Case Rep, 2018, 51: 102-106.
7
Hong GS, Byun JH, Kim JH, et al. Thread sign in biliary intraductal papillary mucinous neoplasm: a novelspecific finding for MRI [J]. Eur Radiol, 2016, 26(9): 3112-3120.
8
Jin KP, Rao SX, Sheng RF, et al. Skewness of apparent diffusion coefficient (ADC) histogram helps predict the invasive potential of intraductal papillary neoplasms of the bile ducts(IPNBs) [J]. Abdom Radiol, 2019, 44(1): 95-103.
9
Yoon HJ, Kim YK, Jang KT, et al. Intraductal papillary neoplasm of the bile ducts: description of MRI and added value of diffusion-weighted MRI [J]. Abdom Imaging, 2013, 38(5): 1082-1090.
10
Angela Tong, Gregory Veillette, Alexandra Budhai, et al. Intraductal oncocytic papillary neoplasm: a benign hepatic cystic neoplasm [J]. BMJ Case Rep, 2017, 2017: bcr2016218139.
11
Lim JH, Zen Y, Jang KT, et al. Cyst-forming intraductal papillary neoplasm of the bile ducts: description of imaging and pathologic aspects [J]. AJR Am J Roentgenol, 2011, 197(5): 1111-1120.
12
Wan XS, Xu YY, Qian JY, et al. Intraductal papillary neoplasm of the bile duct [J]. World J Gastroenterol, 2013, 19(46): 8595-8604.
13
Akira Watanabe, Hideki Suzuki, Norio Kubo, et al. An Oncocytic Variant of Intraductal Papillary Neoplasm of the Bile Duct that Formed a Giant Hepatic Cyst [J]. Rare Tumors, 2013, 5(3): e30.
14
Joo I, Lee JM, Yoon JH. Imaging Diagnosis of Intrahepatic and Perihilar Cholangiocarcinoma: Recent Advances and Challenges [J]. Radiology, 2018, 288(1): 7-13.
15
Zhang Fu-Bo, Zhang Ai-Min, Zhang Zhi-Bin, et al. Preoperative differential diagnosis between intrahepatic biliary cystadenoma and cystadenocarcinoma: A single-center experience [J]. World J Gastroenterol, 2014, 20(35): 12595-12601.
No related articles found!
阅读次数
全文


摘要