肝内胆管囊腺癌的临床与病理

CLINICAL AND PATHOLOGICAL STUDY OF CYSTADENOCARCINOMA IN INTRAHEPATIC BILIARY TRACT

目的 分析肝内胆管囊腺癌的临床及病理特点。方法 通过B超、CT检查及光镜观察分析 14例肝内胆管囊腺癌的主要临床表现。结果 突出的症状为右上腹疼痛及腹胀 ,主要体征是肝大 ,多呈囊性感。B超及CT检查均提示肝囊性占位性病变。根据肝内胆管囊腺癌囊壁癌组织有无浸润至肝实质或肝内扩散 ,可分为两种类型 ,即浸润型 (本组有 8例均于确诊或术后 9～ 3 7个月死亡 )和非浸润性型 (本组有 6例 ,术后均健在)。结论 提出肝内胆管囊腺癌的临床及病理诊断要点。

Objective To analyse the clinical and pathological features of cystadenocarcinoma in the intrahepatic biliary tract. Methods The clinical features of 14 patients with cystadenocarcinoma in intrahepatic biliary tract were analysed in respect to the results of ultrasonic and CT scannings, as well as pathological examination. Results Among the 14 patients, 11 were females and 3 were males. The age of the patients ranged from 32 to 79 years, and mean age was 59.5. The obvious symptoms were right-upper abdominal pain and abdominal distention, and major physical signs were hepatomegaly with cystic feeling. The ultra sonographic and CT scanning revealed cystic space occupying lesions in the liver. According to the invasion or infiltration of carcinoma to the liver tissue, the pathology of cystadenocarcinoma in intrahepatic biliary tract could be categorized into two types: the invading and non-invading. There were 8 patients belonging to the first type and they died 9～37 months after the diagnosis or operation, while 6 patients with no invasion were alive after operation. Conclusion The clinical picture and pathology of cystadenocarcinoma in intrahepatic biliary tract were described. The pathological classification was important in prognosticating the outcome of the patient.