内容紹介
Summary
We encountered 2 cases of colorectal liver metastasis with biliary dilatation mimicking cholangiocarcinoma. Case 1: A 70-year-old male patient, who was diagnosed with colorectal cancer and underwent transverse colectomy 3 years prior, was preoperatively diagnosed with cholangiocarcinoma with biliary dilatation of the medial and lateral segments. He underwent left hemi-hepatectomy. The pathological diagnosis was colorectal liver metastasis with intra-biliary tumor thrombosis. Case 2: A 67-year-old male patient was diagnosed with descending colon cancer and cholangiocarcinoma with biliary dilatation of the medial segment. He underwent left hemi-colectomy and left hemi-hepatectomy. The pathological diagnosis was descending colon cancer and colorectal liver metastasis with biliary infiltration. The immunopathological findings showed double positivity for CK20 and CDX2 antibodies and negativity for CK7 antibody in these cancer lesions.
要旨
症例1は70歳,男性。横行結腸癌に対し右半結腸切除術を施行した。術後3年目にCTでS4肝内胆管の区域性拡張を伴う1 cm大の淡い造影不良域を認め,原発性肝内胆管癌の診断で肝左葉切除術を施行した。組織診断は高分化管状腺癌,胆管には腫瘍塞栓を認めた。免疫染色にてCDX2陽性,CK20は一部で陽性,CK7は陰性で横行結腸癌と同様の組織像であり,大腸癌肝転移と診断した。症例2は67歳,男性。下行結腸癌の術前検査時にCTで肝S4の区域性肝内胆管拡張を伴う2 cm大の淡い造影不良域を認め,下行結腸癌と原発性肝内胆管癌の重複癌の診断で下行結腸切除術および肝左葉切除術,リンパ節郭清の同時手術を施行した。病理組織診断は下行結腸,肝左葉ともに中分化腺癌であり,免疫染色では両者ともにCK19,CK20,CDX2が陽性,CK7は一部陽性,CA19-9は陰性であり,下行結腸癌,Stage Ⅳと診断した。
目次
We encountered 2 cases of colorectal liver metastasis with biliary dilatation mimicking cholangiocarcinoma. Case 1: A 70-year-old male patient, who was diagnosed with colorectal cancer and underwent transverse colectomy 3 years prior, was preoperatively diagnosed with cholangiocarcinoma with biliary dilatation of the medial and lateral segments. He underwent left hemi-hepatectomy. The pathological diagnosis was colorectal liver metastasis with intra-biliary tumor thrombosis. Case 2: A 67-year-old male patient was diagnosed with descending colon cancer and cholangiocarcinoma with biliary dilatation of the medial segment. He underwent left hemi-colectomy and left hemi-hepatectomy. The pathological diagnosis was descending colon cancer and colorectal liver metastasis with biliary infiltration. The immunopathological findings showed double positivity for CK20 and CDX2 antibodies and negativity for CK7 antibody in these cancer lesions.
要旨
症例1は70歳,男性。横行結腸癌に対し右半結腸切除術を施行した。術後3年目にCTでS4肝内胆管の区域性拡張を伴う1 cm大の淡い造影不良域を認め,原発性肝内胆管癌の診断で肝左葉切除術を施行した。組織診断は高分化管状腺癌,胆管には腫瘍塞栓を認めた。免疫染色にてCDX2陽性,CK20は一部で陽性,CK7は陰性で横行結腸癌と同様の組織像であり,大腸癌肝転移と診断した。症例2は67歳,男性。下行結腸癌の術前検査時にCTで肝S4の区域性肝内胆管拡張を伴う2 cm大の淡い造影不良域を認め,下行結腸癌と原発性肝内胆管癌の重複癌の診断で下行結腸切除術および肝左葉切除術,リンパ節郭清の同時手術を施行した。病理組織診断は下行結腸,肝左葉ともに中分化腺癌であり,免疫染色では両者ともにCK19,CK20,CDX2が陽性,CK7は一部陽性,CA19-9は陰性であり,下行結腸癌,Stage Ⅳと診断した。