A CASE OF GALLBLADDER CANCER-ASSOCIATED WITH A COMMON BILE-DUCT NEUROMA, AND A CYSTIC LESION OF THE LIVER WITH HISTOLOGIC-FINDINGS SIMILAR TO THOSE OF AN INFLAMMATORY PSEUDOTUMOR
T. Akiyama et al., A CASE OF GALLBLADDER CANCER-ASSOCIATED WITH A COMMON BILE-DUCT NEUROMA, AND A CYSTIC LESION OF THE LIVER WITH HISTOLOGIC-FINDINGS SIMILAR TO THOSE OF AN INFLAMMATORY PSEUDOTUMOR, Journal of gastroenterology, 30(3), 1995, pp. 408-412
We report a rare case of gallbladder cancer associated with a common b
ile duct neuroma, and a cystic liver lesion with histologic findings s
imilar to an inflammatory pseudotumor, in a patient who had had no pre
vious abdominal surgery. The patient was a 62-year-old man whose major
complaint was fever. Ultrasonography and a computed tomography scan r
evealed gallstones, an elevated lesion in the gallbladder, and a cysti
c liver lesion. Endoscopic retrograde cholangiopancreatography demonst
rated stenosis of the common bile duct. Cultures of the cystic fluid a
nd gallbladder bile were positive for Staphylococcus aureus. The patie
nt underwent hepatectomy (inferior S4, S5, and S6), cholecystectomy, r
esection of the common bile duct, and right hemicolectomy. The resecte
d specimens revealed gallbladder cancer with the microscopic appearanc
e of a papillary adenocarcinoma, and a 12 x 4.5 x 3.5 cm cystic liver
lesion with a wall 7 mm thick. Histologic studies of the wall of the c
ystic liver lesion revealed infiltration by histiocytes and plasma cel
ls, and the presence of fibrous connective tissue, which findings are
characteristic of inflammatory pseudotumors. A 9 x 6 mm elevated lesio
n, with the microscopic appearance of a neuroma, was resected from the
common bile duct.