Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Adenocarcinoma Arising in Segmental Adenomyomatosis of the Gallbladder: A Case Report

담낭의 분절형 선근종증에서 발생한 선암: 증례 보고

  • Yeon, Jin-Sun (Department of Radiology, Chungnam University Hospital) ;
  • Cho, June-Sik (Department of Radiology, Chungnam University Hospital) ;
  • Shin, Kyung-Sook (Department of Radiology, Chungnam University Hospital) ;
  • Lee, Byung-Seok (Department of Internal Medicine, Chungnam University Hospital) ;
  • Lee, Heon-Young (Department of Internal Medicine, Chungnam University Hospital) ;
  • Song, In-Sang (Department of Surgery, Chungnam University Hospital) ;
  • Kang, Dae-Young (Department of Pathology, Chungnam University Hospital)
  • 연진선 (충남대학교병원 영상의학과) ;
  • 조준식 (충남대학교병원 영상의학과) ;
  • 신경숙 (충남대학교병원 영상의학과) ;
  • 이병석 (충남대학교병원 내과) ;
  • 이헌영 (충남대학교병원 내과) ;
  • 송인상 (충남대학교병원 외과) ;
  • 강대영 (충남대학교병원 병리과)
  • Received : 2010.06.17
  • Accepted : 2010.07.25
  • Published : 2010.11.01
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Abstract

We report here a rare case of adenocarcinoma arising from segmental adenomyomatosis of the gallbladder itself. CT images showed segmental annular wall thickening of the gallbladder body with regional lymph node enlargement, which could not exclude adenomyomatosis associated with malignancy. Therefore, we performed MRI and PET/CT for further evaluation. T2 weighted MRI revealed multiple tiny intramural cystic lesions in the focal wall thickening of the gallbladder, suggesting adenomyomatosis. However, PET/CT showed increased activity in the lesion of the gallbladder and regional lymph node, suggesting malignancy, which was pathologically confirmed as adenocarcinoma arising from adenomyomatosis.

저자들은 담낭의 분절형 선근종증 자체에서 발생한 매우 드문 선암의 증례를 보고한다. CT 소견에서 담낭 벽의 국소비후와 국소림프절의 종대를 보여 악성종양을 배제하기 어려워, MR 영상과 PET/CT를 시행하였다. T2 강조 MRI에서 국소비후된 담낭 벽 내 선근종증을 시사하는 미세한 낭성 병변들이 발견되었으나, PET/CT에서는 병변부위와 국소림프절에 양성반응을 보여 악성종양이 의심되었고, 병리소견에서 선근종증에서 발생한 선암으로 확진되었다.

Keywords

References

  1. Aldridge MC, Gruffaz F, Castaing D, Bismuth H. Adenomyomatosis of the gallbladder. A premalignant lesion? Surgery 1991;109: 107-110
  2. Katoh T, Nakai T, Hayashi S, Satake T. Noninvasive carcinoma of the gallbladder arising in localized type adenomyomatosis. Am J Gastroenterol 1988;83:670-674
  3. Kawarada Y, Sanda M, Mizumoto R, Yatani R. Early carcinoma of the gallbladder, noninvasive carcinoma originating in the Rokitansky-aschoff sinus: a case report. Am J Gastroenterol 1986; 81:61-66
  4. Nakafuji H, Koike Y, Wakabayashi M, Furihata R, Maruyama Y, Ogata H. Three cases of early stage carcinoma of the gallbladder. Gastroenterol Jpn 1981;16:134-140
  5. Sakurai T, Saji Y, Kazui K, Yamaga S, Hirose K, Shinohara T, et al. A case of early carcinoma of the gall-bladder arising in adenomyomatosis detected by endoscopic ultrasonography. Nippon Shokakibyo Gakkai Zasshi 1995;92:1304-1308
  6. Meguid MM, Aun F, Bradford ML. Adenomyomatosis of the gallbladder. Am J Surg 1984;147:260-262 https://doi.org/10.1016/0002-9610(84)90102-8
  7. Ootani T, Shirai Y, Tsukada K, Muto T. Relationship between gallbladder carcinoma and the segmental type of adenomyomatosis of the gallbladder. Cancer 2006;69:2647-2652
  8. Yoshimitsu K, Honda H, Aibe H, Shinozaki K, Kuroiwa T, Irie H, et al. Radiologic diagnosis of adenomyomatosis of the gallbladder: comparative study among MRI, helical CT, and transabdominal US. J Comput Assist Tomogr 2001;25:843-850 https://doi.org/10.1097/00004728-200111000-00003
  9. Haradome H, Ichikawa T, Sou H, Yoshikawa T, Nakamura A, Araki T, et al. The pearl necklace sign: an imaging sign of adenomyomatosis of the gallbladder at MR cholangiopancreatography. Radiology 2003;227:80-88 https://doi.org/10.1148/radiol.2271011378