頁籤選單縮合
題 名 | Xanthogranulomatous Cholecystitis=黃色肉芽腫膽囊炎 |
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作 者 | 周楠華; 莫景棠; 吳建德; 張宏泰; 劉絮穎; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 26:6 民82.11-12 |
頁 次 | 頁2069-2073 |
分類號 | 416.247 |
關鍵詞 | 黃色肉芽腫膽囊炎; Xanthogranulomatous cholecystitis; XGC; Cholecystectomy; |
語 文 | 英文(English) |
中文摘要 | 黃色肉芽腫臆囊炎,是一種較嚴重慢性膽囊炎。從1990到1992,本院共有324例膽囊切除標本,其中8例,經病理診斷為黃色肉芽腫膽囊炎,發生率為2.5%,臨床主要症狀是右上腹疼痛。手術前經由放射線影像檢查,沒有任何病例得到正確診斷。這些病灶,在外觀下,膽囊壁有不規則結節性增厚,很像腫瘤。由於以上兩點,在手術當中獲得正確診斷及決定手術方法,對外科醫生是項挑戰。因此,冰凍切片是必須的。一旦診斷確定,行膽囊切除術即可。這8例中,7例(87.5%)合併膽結石,2例(25%)合併膽道惡性腫瘤。這些節結,在顯微鏡下,由發泡狀的組織細胞,發炎細胞,及纖維化組織組成。此病變之發生機轉,可能因膽囊發炎或膽道阻塞,造成RokitanskyAschoff sinuses破裂,膽酯釋出到鄰近組織,引發炎症反應而產生此特殊改變。 |
英文摘要 | From 1990 to 1992, 8 cases of xanthogranulomatous cholecystitis ( XGC ) were diagnosed pathologically among 324 cholecystectomy specimens in this hospital. Rupture of Rokitansky-Aschoff sinuses caused by inflammation or calculous obstruction with liberation of bile into the wall is the pathogenesis of the XGC. The incidence of XGC was 2.5% in this series. Right upper quadrant pain was the leading clinical manifestation. No case was preoperatively diagnosed by image studies. The microscopic characteristics of XGC are foamy histiocytes ( xanthomatous cells ), granulomatous reaction with giant cells and fibrosis, all of which were found in all cases of present series. Grossly, the wall of the gallbladder showed irregular nodular thickening, and mimicked carcinoma. These aspects provided an unexpected challenge for intraoperative diagnosis. Thus, a frozen biopsy is mandatory to rule out malignancy. Of these cases, 87.5% were associated with gall stones and 25%, with biliary malignancy. |
本系統中英文摘要資訊取自各篇刊載內容。