化生上皮をもつ胆囊にみられたびまん性papillomatous cholesterosisの1例

Diffuse Papillomatous Cholesterosis in Gallbladder with Metaplastic Epithelium, a Case Report

　われわれは，化生上皮をもつ胆囊にみられた，びまん性papillomatous cholesterosisの1例を経験し，組織化学的ならびに電顕的観察を行い2，3の興味ある成績を得たので若干の考察を加え報告する．

症例

　患　者：54歳　女性

　現病歴：1965年頃より時折右季肋部痛があった．1976年8月以来とう痛が激しくなり，嘔気，嘔吐を伴うようになったため当院第1内科受診，DIC，EPCG等の諸検査の結果，胆石症が疑われ，1977年1月19日当院第1外科に入院した．

　The third case in Japan of diffuse papillomatous cholesterosis in the gallbladder in a 54-year-old woman is reported with discussion about the pathogenesis and the relation to co-existent metaplastic epithelium by transmission and scanning electron microscopy and histochemical investigations.

　The papillomatous cholesterosis, showing multiple polypoid lesions the size of a red bean to rice-grain, was covered by a single layer of columnar or cuboidal epithelial cells with and without cholesterol crystals in their cytoplasms. No surface and other structural differences were observed by transmission and scanning electron microscopy. No metaplastic epithelium was detected in the polyps.

　The metaplastic epithelium was distributed diffusely on the mucosa, consisting of goblet cells with neutral mucin and pseudopyloric glands with neutral mucin or sulphated acid mucin. The histochemical reaction and the distribution of these cells were somewhat different from those of the previous reports.