Spindle Cell-Type Undifferentiated Carcinoma of the Common Bile Duct of the Hepatic Hilus
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概要
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Spindle cell-type undifferentiated carcinoma arising from the extrahepatic bile duct is extremely rare. We report herein a case of this type of carcinoma in the common bile duct of the hepatic hilus. A 59-year-old man was admitted to our hospital complaining of jaundice. Laboratory data revealed elevation of serum CA 19-9. Cholangiography revealed complete obliteration of the left hepatic bile duct and stenosis of the bile duct from the superior to the right hepatic bile duct. Computed tomography showed the tumor, measuring 15×12 mm, in the hepatic hilus, obliteration of the right to main trunk of the portal vein and a lymph node in the hepato-duodenum ligament swelling. Arteriography revealed a kink of the right hepatic artery, so encasement of the right hepatic artery was suspected. We preoperatively diagnosed hilus bile duct carcinoma and scheduled right trisection hepatectomy. Intraoperative frozen sections taken from the tumor and tissues around hepatic arteries showed spindle cells and inflammatory cells, so inflammatory pseudotumor was diagnosed intraoperatively. Because the right hepatic bile duct was occluded, right lobe hepatectomy was performed. However, permanent section revealed both spindle cells and poorly differentiated tubular adenocarcinoma cells positive for CAM5.2, AE1/AE3 and vimentin. Based on these findings, the tumor was finally diagnosed as spindle cell-type undifferentiated carcinoma. The patient died of pulmonary infarction 11 days after the operation.
- Springer Japanの論文
著者
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Kondo Satoshi
斗南病院 外科
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NAKANUMA Yasuni
Department of Human Pathology, Kanazawa University Graduate School of Medicine
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Zen Yoh
Department Of Human Pathology Kanazawa University Graduate School Of Medicine
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Nakanuma Yasuni
金沢大学がん研究所 腫瘍内科
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KAWAKAMI HIROSHI
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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Katoh Hiroyuki
Department Of Surgery Tonan Hospital
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Kondoh Satoshi
Second Department Of Surgery Hokkaido University School Of Medicine
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Nakanuma Yasuni
2nd Department Of Pathology School Of Medicine Kanazawa University
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Nakanishi Yoshitsugu
北海道大学 医学研究科消化器内科
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Nagao Yasuyuki
Third Department Of Internal Medicine Kyoto Prefectural University Of Medicine
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Nakatsuji Yoshiyuki
Department Of Pediatrics Shinshu University School Of Medicine
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Kanamori Hiroe
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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Kobayashi Hajime
Fourth Department Of Internal Medicine Obihiro Kosei Hospital
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Nakanishi Yoshitsugu
Department Of Surgical Oncology Division Of Cancer Medicine Hokkaido University Graduate School Of M
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Nakayama Yoshiko
Department Of Human Pathology Kanazawa University Graduate School Of Medicine
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Nakayama Yoshiko
Department Of Pediatrics Shinshu University School Of Medicine
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