胆囊炎性肌纤维母细胞瘤1例

A Case Report of Inflammatory Myofibroblastic Tumor of the Gallbladder

目的:通过病例回顾,提高对胆囊炎性肌纤维母细胞瘤的认识、诊断和治疗。方法:总结1例经病理证实的胆囊炎性肌纤维母细胞瘤患者的临床资料,并复习相关文献资料。结果:患者临床表现为右上腹、剑突下隐痛。CT示胆囊壁增厚,局部可见片状软组织密度影,增强扫描呈中度强化,局部与肝实质界限不清。MR示胆囊颈部可见类圆形短T2信号影,胆囊底部可见不规则团块状异常信号影,以稍长T1稍长T2信号为主,边界清晰,DWI呈稍高信号影,增强呈明显延迟强化,病灶与邻近肝实质界限不清。胆囊病灶术后病理确诊为胆囊炎性肌纤维母细胞瘤伴坏死。结论:胆囊炎性肌纤维母细胞瘤属于良性肿瘤,其在胆囊中的发生率极低,临床表现不典型,影像学缺乏特异性,确诊仍依赖于病理。手术为其主要的治疗方法,但易复发,因此应加强对其随访。

Objective: To improve the understanding, diagnosis and treatment of inflammatory myofibroblastic tumor (IMT) in gallbladder through the review of the case. Methods: The clinical data of a case of pathologically proved IMT in gallbladder was reported and relevant literatures were reviewed. Re-sults: The patient felt dull pain in the right upper abdomen and below xiphoid. CT showed thicken-ing of the gallbladder wall, local patchy soft tissue density, moderate enhancement with contrast, and unclear local boundary with liver parenchyma. MR showed circular and short T2 signal in the neck of the gallbladder, irregular regiment massive in the bottom of the gallbladder, mainly with slightly long T1 and long T2 signal, with clear boundary;DWI showed slightly high signal, and the enhancement showed obvious delayed enhancement, and the boundary between the lesion and the adjacent liver parenchyma was unclear. The pathological diagnosis of the gallbladder lesion was in-flammatory myofibroblastic tumor with necrosis. Conclusion: IMT is a benign tumor and is rare in the gallbladder. The clinical manifestations are not typical and the imaging manifestations are not specific. lts diagnosis depends on pathology. Surgery is the main treatment, but IMT has the ten-dency of recurrence, so its postoperative follow-up is of great significance.