胆囊的扩散性大B细胞淋巴瘤与肝腺入侵,表现出死亡倾向
Hironao Matsumoto1, Shunsuke Horitani2, Yutaro Tokutomi1
1Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University Medical Center, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
Clinical journal of gastroenterology
|September 10, 2024
概括
诊断胆囊扩散型大B细胞淋巴瘤 (DLBCL) 是由于缩而具有挑战性的. 可行的组织的向超声波导向活检使得最终的DLBCL诊断成为可能.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种侵略性的非霍奇金淋巴瘤.
- 胆囊DLBCL很少见,通常表现为非特异性症状.
- 肝腺入侵使诊断和分期变得复杂.
研究的目的:
- 报告一种具有挑战性的胆囊DLBCL病例,并有肝两入侵.
- 为了突出瘤死所带来的诊断困难.
- 证明针对性活检在实现最终诊断方面的有用性.
主要方法:
- 一个71岁的男性患有腹部疼痛的案例介绍.
- 最初的成像 (CT,EGD) 表明胆囊和十二指肠受影响.
- 组织学分析因广泛的亡而复杂化;内镜逆行胆血管学活检非诊断.
- 与对比度增强的超声波识别了可供活检的可活组织.
- 超声指导的核心针活检,然后进行免疫组织化学 (CD10,CD20,BCL-6,C-Myc).
主要成果:
- 计算机断层扫描显示了胆囊与空气的膨胀,并怀疑肝腹入侵.
- 最初的活检只显示了死组织,阻碍了诊断.
- 对比超声波显示了侵袭部位的可活组织.
- 超声导向活检揭示了具有DLBCL免疫表型 (CD10+,CD20+,Bcl-6+,C-Myc+) 的非典型淋巴细胞.
结论:
- 患有广泛亡的胆囊DLBCL存在重大诊断挑战.
- 针对性活性的组织活检,以对比增强超声波为指导,对于诊断至关重要.
- 免疫组织化学对于证实DLBCL在死亡组织病例中至关重要.
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