摘要
Xanthogranulomatous 胆汁(XGC ) 是胆囊的破坏煽动性的疾病，很少包含邻近的机关并且模仿国王先进胆囊癌。诊断在病理学的检查以后仅仅通常是可能的。46 42 岁的女人被指我们包含肝核，正确的肝脑叶，恰好结肠的弯曲，和十二指肠的怀疑的胆囊癌症的中心。刷细胞学获得了由内视镜后退胆管造影术(ERC ) 出现了高级发育异常。病人经历了团的在团体切除术，由正确叶切除术，正确的半结肠切除术，和部分十二指肠的切除术组成。出人意料地揭示的病理学的检查一 XGC.Only，为有邻近的机关的直接参与的 XGC 的扩大外科的切除术的六个案例到目前为止被报导了。在这些情况中，与癌给 XGC 的可能的共存，恶意不能被排除，甚至在细胞学和 intraoperative 冰冻切片调查以后。在结论，由于源于在另外的方面上包围机关的高度好攻击的煽动性的侵略的一个方面和可能的复杂并发症上的胆囊癌的差的预后，它似乎这些案例应该被当作恶性瘤直到不那样证明。临床医生们应该包括 XGC 在之中可能微分在肝核群众诊断。
Xanthogranulomatous cholecystitis （XGC） is a destructive inflammatory disease of the gallbladder, rarely involving adjacent organs and mimicking an advanced gallbladder carcinoma. The diagnosis is usually possible only after pathological examination. A 46 year-old woman was referred to our center for suspected gallbladder cancer involving the liver hilum, right liver lobe, right colonic flexure, and duodenum. Brushing cytology obtained by endoscopic retrograde cholangiography （ERC） showed high-grade dysplasia. The patient underwent an en-bloc resection of the mass, consisting of right Iobectomy, right hemicolectomy, and a partial duodenal resection. Pathological examination unexpectedly revealed an XGC. Only six cases of extended surgical resections for XGC with direct involvement of adjacent organs have been reported so far. In these cases, given the possible coexistence of XGC with carcinoma, malignancy cannot be excluded, even after cytology and intraoperative frozen section investigation. In conclusion, due to the poor prognosis of gallbladder carcinoma on one side and possible complications deriving from highly aggressive inflammatory invasion of surrounding organs on the other side, it seems these cases should be treated as malignant tumors until proven otherwise. Clinicians should include XGC among the possible differential diagnoses of masses in liver hilum.
关键词
手术治疗
肉芽肿
胆囊疾病
胆囊癌
Xanthogranulomatous cholecystitis
Gallbladder cancer
Gallbladder carcinoma
