胆囊腺肌瘤性增生(附45例临床病理分析)

目的探讨胆囊腺肌瘤性增生的临床病理特征。方法对45例胆囊腺肌瘤性增生的临床资料及影像学及病理形态学进行回顾性分析。结果1190例手术切除胆囊标本见胆囊腺肌瘤性增生45例(3.78%)。28例为局限型(62.00%),多在胆囊底部,节段型和弥散型分别10例和7例。各型病变表现黏膜上皮增生,下陷入肌层形成RA氏窦,并且腺体可有不同程度的增生及不典型性增生、囊壁平滑肌增生。其中1例节段型腺肌瘤性增生伴腺癌,其内可见异型增生与癌有移行,1例局限型腺肌瘤增生合并乳头状腺瘤。结论胆囊腺肌瘤增生是一种良性病变,主要由于长期慢性炎症修复增生引起,少数可引起恶性变,故以早期手术切除为宜。

Clinical Pathological Analysis on 45 Cases of Adenomyomatous Hyperplasia of the Gallbladder

Objective Aim To investigate the clinical pathological characteristic of Adenomyomatous Hyperplasia of the Gallbladder(AHG).Methods Statistic analysis was performed for the clinical files,radiological and ultrasound and pathological data obtained form 45 cases of resected AHG.Results 28 cases presented local-limited(62.00%),mostly in the bottom of gallbladder,10 cases presented segmental-typed,7 cases presented diffuse-typed.Every pathological changes presented mucosal epidermis hyperplasia cave in muscle form Rokitansky-Aschoff(R-A),and gland could have different degree hyperplasia and untypical hyperplasia,bursa leiomy hyperplasia.1 case segmental-typed adenomyomatous hyperplasia consolidated adenocarcinoma,with heterohyperplasia and carcinoma,1 case presented local-limited adenomyomatous hyperplasia consolidated mastoid adenomyomatous.Conclusion AHG is a benign pathological changes,mostly is due to perennial.Chronic inflammation rehab hyperplasia,minority could bring malignant pathological changes,So it is best to have a surgery in earlier.