Gao F, Zhao H, Chen X, Dong X, Liu T, Fu X. Gallbladder non-Hodgkin's lymphoma: Case report.
Int J Surg Case Rep 2019;
61:218-221. [PMID:
31377548 PMCID:
PMC6698641 DOI:
10.1016/j.ijscr.2019.07.064]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 12/03/2022] Open
Abstract
The patient was hospitalized for “intermittent fever, abdominal pain for 19 days” and then underwent laparoscopic cholecystectomy. After the operation, the patient’s condition deteriorated and eventually died. Postoperative pathological diagnosis confirmed gallbladder non-Hodgkin’s lymphoma.
Gallbladder non-Hodgkin’s lymphoma is very rare, and this case also includes hemophagocytic syndrome and bile duct disappearance syndrome, which is rare. This case is described from the onset of the patient to the hospital visit and postoperative conditions.
Bile duct disappearance syndrome (VBDS) is a syndrome characterized by reduced intrahepatic bile ducts as a pathological feature and cholestasis as the main clinical manifestation.
Hemophagocytic syndrome (HPS) is a group of heterogeneous diseases characterized by over-inflammatory responses due to hereditary or acquired immunodeficiency.
Introduction
Extrahepatic biliary non-Hodgkin’s lymphoma (EBNHL) is rare, with a prevalence of 0.6% of malignant biliary tumors. Primary biliary non-Hodgkin’s lymphoma accounts for 0.4% of extranodal non-Hodgkin’s lymphoma (NHL), accounting for approximately 0.016% of all NHL cases. The patient presented with typical bile duct disappearance syndrome. The late performance is a bloodthirsty syndrome.
Presentation of case
This patient was admitted to the hospital with “intermittent fever, abdominal pain for 19 days”. The relevant laboratory tests showed severe infection. The patients were treated according to abdominal infection, and then laparoscopic cholecystectomy was performed. After the operation, the patient's condition did not relieve and further deteriorated. Postoperative patient performance was not based on preoperative estimates, and surgery did not achieve the desired results. Postoperative pathological diagnosis confirmed gallbladder non-Hodgkin’s lymphoma. The patient eventually died.
Discussion
Non-calculus inflammation occurs more frequently in the gallbladder. Non-calculus infections are generally caused by bile stasis and ischemia, resulting in bacterial reproduction and reduced blood supply, and gangrene and perforation of the gallbladder are more likely to occur. This patient is also diagnosed and treated according to this idea. The development after surgery completely exceeded our expectations. Gallbladder non-Hodgkin’s lymphoma is very rare, and this case also includes hemophagocytic syndrome and bile duct disappearance syndrome, which is rare.
Conclusion
Malignant lymphoma of the extrahepatic biliary system is extremely rare, and its clinical manifestations are easily misdiagnosed. At the same time, non-calculous cholecystitis with fever, jaundice and hepatosplenomegaly should be considered.
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