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Adenosquamous carcinoma arising in a duplication cyst of the gallbladder

Hepatobiliary Surgery and Nutrition 2018年第4期7卷 317-319页

作者： Arie Ariche Michael Schvimer yael inbar yael Dreznik Department of Hepatobiliary Surgery Chaim Sheba Medical CenterTel HaShomerIsrael(Affiliated to the Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael) Institute of Pathology Chaim Sheba Medical CenterTel HaShomerIsrael(Affiliated to the Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael) Diagnostic Imaging Department Chaim Sheba Medical CenterTel HaShomerIsrael(Affiliated to the Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael) Department of Surgery and Transplantation Chaim Sheba Medical CenterTel HaShomerIsrael(Affiliated to the Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael)

A 52-year-old woman,previously healthy was admitted to another hospital due to right upper quadrant abdominal pain,fever and *** ultrasound demonstrated acute cholecystitis and lesion 8 *** diameter near the *** abdominal CT scan showed the lesion in close proximity to the gallbladder,with fat infiltration.A percutaneous drainage of the lesion under CT guidance yielded a substance which was bloody and purulent in *** patient improved clinically under antibiotics and was discharged from hospital with a recommendation for elective exploratory laparoscopy.

关键词： gallbladder admitted acute

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Ciliated hepatic foregut cyst with high intra-cystic carbohydrate antigen 19-9 level

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World Journal of Gastroenterology 2014年第43期20卷 16355-16358页

作者： Ziv Ben Ari Oranit Cohen-Ezra Jonathan Weidenfeld Tania Bradichevsky Ella Weitzman Uri Rimon yael inbar Michal Amitai Barak Bar-Zachai Roni Eshkenazy Arie Ariche Daniel Azoulay Liver Disease Center Sheba Medical Center and Sackler School of MedicineTel Aviv University52621 Tel AvivIsrael Department of Pathology Sheba Medical Center and Sackler School of MedicineTel Aviv University52621 Tel AvivIsrael Department of Radiology Sheba Medical Center and Sackler School of MedicineTel Aviv University52621 Tel AvivIsrael Depatrment of Hepatobiliary Surgery Sheba Medical Center and Sackler School of MedicineTel Aviv University52621 Tel AvivIsrael

A ciliated hepatic foregut cyst (CHFC) is a rare foregut developmental malformation usually diagnosed in adulthood. Five percent of reported cases of CHFC transform into squamous cell carcinoma. We report the presentation, evaluation, and surgical management of a symptomatic 45-year-old male found to have a 6.2 cm CHFC. Contrast tomography-guided fine-needle aspiration demonstrated columnar, ciliated epithelium consistent with the histologic diagnosis of CHFC. The intracystic levels of carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were extremely high (978118 U/mL and 973 μg/L, respectively). Histologically, the wall of the cyst showed characteristic pseudopapillae lined with a ciliated stratified columnar epithelium, underlying smooth muscle, an outer fibrous layer and no atypia. Immunohistochemistry for CA19-9 and CEA was positive. This is the first case report of a CHFC in which levels of CA 19-9 and CEA were measured. Our findings suggest that a large sized multilocular cyst and elevated cyst CA19-9 and CEA levels do not exclude a CHFC from consideration in the diagnosis. CHFCs should be included in the differential diagnosis of hepatic lesions. Accurate diagnosis of a CHFC is necessary given its potential for malignant transformation, and surgical excision is recommended.

关键词： Ciliated hepatic foregut cyst Carbohydrate antigen 19-9 Carcinoembryonic antigen Computed tomography-guided fine-needle aspiration Magnetic resonance imaging Squamous cell carcinoma

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