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Neuroendocrine carcinoma of the gall bladder in a young lady presenting with upper abdominal heaviness: a common complaint and a rare diagnosis

机译:胆囊的神经内分泌癌在一位年轻女士呈现上腹部沉重的血液沉重:常见投诉和罕见的诊断

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摘要

A 34-year-old woman was referred from internal medicine with complaints of occasional upper abdominal heaviness and pain for 4 months. Her WHO performance score was 1. On examination, she was icteric and had multiple, brownish nodular skin lesions on limbs and back that were soft to firm in consistency. On per abdominal examination, the liver span was approximately 5 cm below the right subcostal margin at midclavicular line. She underwent CT scan of the abdomen, which revealed an ill-defined heterogeneously enhancing lesion in the gall bladder fossa infiltrating adjacent liver parenchyma, duodenum and the common bile duct at the porta hepatis (figure 1A–L). Her biopsy revealed liver parenchyma infiltrated by tumour cells with hyperchromatic nucleus, fine chromatin, inconspicuous nucleoli and scant cytoplasm (figure 2A,B). Tumour cells were positive for synaptophysin and showed high MIB1 labelling index (figure 2C,D). A diagnosis of neuroendocrine carcinoma of gall bladder was made. She was discussed in tumour board and was offered palliative chemotherapy.
机译:一名34岁的女子从内科偶有上腹沉重和疼痛的4个月的投诉称。她的人表现评分为1。检查发现,她是黄疸和对四肢和背部那名软公司在一致性多,褐色结节性皮损。每腹部检查,肝跨度低于在锁骨中线右肋缘约5厘米。她接受CT扫描腹部,这揭示了在胆不明确的非均相强化病灶浸润窝相邻的肝实质,十二指肠和在肝门胆总管(图1A-L)的。她的活检显示由肿瘤细胞深染核,染色质细,不显眼的核仁和胞浆少(图2A,B)浸润肝实质。肿瘤细胞表达突触素和表现出较高的MIB1标记指数(图2C,d)。胆的神经内分泌癌的诊断为。她在肿瘤委员会讨论,并提供姑息性化疗。

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