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Luschka duct proliferation of gall bladder, mimicking adenocarcinoma:A case report

عنوان مقاله: Luschka duct proliferation of gall bladder, mimicking adenocarcinoma:A case report
شناسه ملی مقاله: AFZMED02_007
منتشر شده در دومین کنگره بین المللی پزشکی افضلی پور در سال 1397
مشخصات نویسندگان مقاله:

Elham Jafari - Pathology and Stem Cell Research Center, Pathology Department, Afzalipour School of Medicine, University of Medical Sciences, Kerman, Iran.
Tahereh Tohidi - Pathology and Stem Cell Research Center, Pathology Department, Afzalipour School of Medicine, University of Medical Sciences, Kerman, Iran
Maryam Mohit - Pathology and Stem Cell Research Center, Pathology Department, Afzalipour School of Medicine, University of Medical Sciences, Kerman, Iran
Bahram Pourseyedi - Surgery Department, Kerman University of Medical Sciences, Kerman, Iran.

خلاصه مقاله:
Back ground: Luschka ducts are small bile duct within the gall bladder fossa. This region not covered by serosa and located between connective tissue of gall bladder and liver. Thisis a normal anatomical variant and seen in up 10% cholecystectomy specimens. We describe here a cholecystectomy specimen with proliferation of luschka that mimicking anadenocarcinoma of gall bladder Case report: A 40 years old man referred with signs and symptoms of cholecystitis.After cholecystectomy the gall bladder diameter was 7.5*4 cm, with dilated lumen and ulcerative mucosa. Maximum wall thickness was 0.3 cm and multiple small yellow gall stones were seen. Outer surface shows mild irregularity. Microscopically gall bladder wall was seen with eroded mucosa and fibroblastic proliferation beneath the serosa. Focally hepatic tissue and hyperplastic ducts aggregate of glandular structures, surrounded by concentric fibrosis were present. In multiple sections examined no lymphovascular invasion was seen but minimal nuclear atypia was evident. IHC study for ki67 show low mitotic index and for P53 show unsatisfactory reaction. Conclusion: The most important differential diagnosis of proliferative luschka ducts is gall bladder well differentiated adenocarcinoma. Helpful clues in diagnosis include luschka ducts specific location (non peritonealized gall bladder fossa), collagen fibers surrounding luschka ducts and lack of infiltrative growth pattern. The degree of cytologic atypia and mitotic activity, presence of lymphovascular and perineural invasion are also important.Immunohistochemistry show high Ki67 and diffuse nuclear P53 in tumoral tissue comparison with benign luschka ducts proliferation. We believe that differential diagnosisrests upon the H&E findings and IHC may be helpful. Also pathologist knowledge of these morphologically characteristics is necessary to prevent misdiagnosis.

کلمات کلیدی:
luschka ducts, proliferation, gall bladder

صفحه اختصاصی مقاله و دریافت فایل کامل: https://civilica.com/doc/812820/