Angio-CTで進展度を確実に診断しえた胆囊癌の1例

Carcinoma of the Gallbladder in Which Angio-CT was Crucial in Making a Final Diagnosis on the Degree of Invasion, Report of a Case

要旨　症例は62歳の女性で画像診断で発見された胆囊体部内面の1.5cm前後の隆起性病変について，ERCP，CTの単独検査では胆囊内の隆起性早期癌を疑ったが，血管造影でsuperficial branchにencasementを認め漿膜に達する進行癌と，ほぼ診断されたが，血管造影とCTの同時併用によるAngio-CTではhigh density areaが隆起のみでなく，胆囊壁に及んで，隆起性進行癌であることを確診しえた．組織学的に一部漿膜に達する進行癌であった．胆囊癌に対してAngio-CTの同時併用により進展度を確診しえた症例を報告し，画像診断におけるERCP，CT，Angioの併用検査の有用性を強調したい．

　We report a case of carcinoma of the gallbladder in which angio-CT was crucial in making a final diagnosis on the degree of invasion.

　An elevated lesion of about 1.5 cm in diameter was first noted in the gallbladder by ultrasound in a 62 year-old female. Subsequently performed ERCP and conventional CT scan suggested an elevated type early carcinoma of the gallbladder.

　Although angiography alone was useful in showing encasement of superficial branches due to cancer invasion reaching the serous membrane, angio-CT further demonstrated a high density area in the wall as well as in the elevated lesion, which confirmed an elevated type advanced carcinoma. Histological examination was compatible with the above findings.

　Thus, a combination of ERCP, CT and angiography may be very useful in making a diagnosis of carcinoma of the gallbladder.