臨牀消化器内科 Vol.34 No.2(2)


特集名 胆囊癌診療の現況
題名 胆囊癌の病理
発刊年月 2019年 02月
著者 佐々木 素子 金沢大学医薬保健研究域医学系人体病理学
【 要旨 】 胆囊癌は，胆管癌，乳頭部癌と同様に胆道癌に含まれ，基本的な病理形態像は胆管癌と同様，高～中分化型管状腺癌が多い．多くは浸潤癌であるが，非浸潤癌/前癌病変として，胆管と同様に，胆囊内乳頭状腫瘍（ICPN）や胆管上皮内腫瘍（BilIN）がある．近年，胆石症などの切除検体で発見される偶発癌が注目されている．また，切除胆囊にICPNやBilINが偶発することもある．胆囊癌を高率に合併する膵胆管合流異常症には，広範に粘膜の過形成性変化やBilINがみられることが多い．胆囊癌特有の事項として，Rokitansky-Aschoff洞（RAS）や癌のRAS内進展と浸潤癌の鑑別，進行癌と黄色肉芽腫性胆?炎の鑑別が挙げられる．
Theme The Current Status of Management of Gallbladder Cancer
Title Pathology of Gallbladder Carcinoma
Author Motoko Sasaki Department of Human Pathology, Kanazawa University Graduate School of Medical Sciences
[ Summary ] Gallbladder carcinoma belongs to biliary tract carcinoma as well as bile duct carcinoma and ampullary carcinoma. The histopathology of gallbladder carcinoma is almost the same as bile duct carcinoma. Intracystic papillary (-tubular) neoplasm (ICPN) and biliary intraepithelial neoplasia (BilIN) are known as non-invasive/precancerous lesions in the gallbladder. Incidental gallbladder carcinoma is sometimes detected in gallbladders resected for cholecystolithiasis and BilIN and ICPN may also be found incidentally. Characteristic issues of gallbladder carcinoma include differential diagnosis between invasive carcinoma and Rokitansky-Aschoff sinus (RAS), as well as expansion of carcinoma into RAS and xanthogranulomatous cholecystitis.
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