内容紹介
Gallbladder Malignant Lymphoma Diagnosed after Surgery for Acute Cholecystitis―A Case Report
Summary
An 84-year-old man visited our hospital with epigastralgia. Levels of hepatic and biliary enzymes and CRP were elevated, as detected by a blood test. On a CT scan, a swollen gallbladder with stones was detected. The patient was admitted to the hospital with a diagnosis of Grade Ⅰ acute cholecystitis. Conservative treatment was continued with antibiotic administration and the patient was discharged from the hospital with improvement on day 6 after admission. Three months later, the patient underwent laparoscopic cholecystectomy. In the gallbladder, a 45×45 mm tumor was found. Upon pathological examination, diffuse proliferation of lymphocyte-like heterotypic cells and subserosal invasion were observed. Immunohistochemistry results were negative for MUM1 and positive for CD10 and Bcl6 markers. A malignant diffuse large B-cell lymphoma was diagnosed. We experienced a case of malignant lymphoma of the gallbladder diagnosed after surgery for acute cholecystitis, which we herein report with literature consideration.
要旨
症例は84歳,男性。心窩部痛を主訴に当院救急外来を受診した。血液検査で肝胆道系酵素と炎症反応の上昇を認めた。CTで腫大した胆嚢と胆嚢結石を認め,急性胆嚢炎Grade Ⅰの診断で当院外科に入院となった。抗菌薬投与で保存的治療を開始し,入院6日目に軽快退院となった。待機的手術の方針となり,約3か月後に腹腔鏡下胆嚢摘出術を施行した。術後経過良好で術後6日目に退院となった。摘出した胆嚢の頸部には45×45 mm大の隆起性病変を認め,組織学的にはリンパ球様異型細胞のびまん性増殖と漿膜下までの浸潤を認めた。免疫染色ではCD10(+),Bcl6(+),MUM1(-)となり,びまん性大細胞型B細胞リンパ腫と診断された。今回われわれは,急性胆嚢炎術後に診断された胆嚢悪性リンパ腫の1例を経験したので,文献的考察を加えて報告する。
目次
Summary
An 84-year-old man visited our hospital with epigastralgia. Levels of hepatic and biliary enzymes and CRP were elevated, as detected by a blood test. On a CT scan, a swollen gallbladder with stones was detected. The patient was admitted to the hospital with a diagnosis of Grade Ⅰ acute cholecystitis. Conservative treatment was continued with antibiotic administration and the patient was discharged from the hospital with improvement on day 6 after admission. Three months later, the patient underwent laparoscopic cholecystectomy. In the gallbladder, a 45×45 mm tumor was found. Upon pathological examination, diffuse proliferation of lymphocyte-like heterotypic cells and subserosal invasion were observed. Immunohistochemistry results were negative for MUM1 and positive for CD10 and Bcl6 markers. A malignant diffuse large B-cell lymphoma was diagnosed. We experienced a case of malignant lymphoma of the gallbladder diagnosed after surgery for acute cholecystitis, which we herein report with literature consideration.
要旨
症例は84歳,男性。心窩部痛を主訴に当院救急外来を受診した。血液検査で肝胆道系酵素と炎症反応の上昇を認めた。CTで腫大した胆嚢と胆嚢結石を認め,急性胆嚢炎Grade Ⅰの診断で当院外科に入院となった。抗菌薬投与で保存的治療を開始し,入院6日目に軽快退院となった。待機的手術の方針となり,約3か月後に腹腔鏡下胆嚢摘出術を施行した。術後経過良好で術後6日目に退院となった。摘出した胆嚢の頸部には45×45 mm大の隆起性病変を認め,組織学的にはリンパ球様異型細胞のびまん性増殖と漿膜下までの浸潤を認めた。免疫染色ではCD10(+),Bcl6(+),MUM1(-)となり,びまん性大細胞型B細胞リンパ腫と診断された。今回われわれは,急性胆嚢炎術後に診断された胆嚢悪性リンパ腫の1例を経験したので,文献的考察を加えて報告する。