|
KMID : 0371319680100040273
|
|
Journal of the Korean Surgical Society
1968 Volume.10 No. 4 p.273 ~ p.281
|
|
|
Primary carcinoma of Liver Induced by Clonorchis Sinensis
|
|
金勇一/Kim, Yong IL
宋運永/李會白/李龍海/金榮祐/Song, Woon Young/Lee, Hoi Paik/Lee, Yong Hae/Kim, Young U
|
|
|
Abstract
|
|
|
A case of clonorchiasis associated with primary carcinoma of liver and metastasis to musculus rectus abdominis in a fifty-six-year-old male is reported.
The patient was admitted to the Wonju Union Christian Hospital in Nov. 1964 with persistent right upper quadrant pain, jaundice, and general malaise. Exploratory laparatomy revealed the gallbladder, intra and extra-hepatic biliary passages filled with 3,000 to 4,000 adult worms of clonorchis sinensis causing biliary obstruction. Microscopic examination of the biopsied liver showed a marked adenomatous hyperplasia of bile ducts, intense eosinophilic infiltration in the widened portal spaces, edema and fibrosis of periductal area, extreme bile stasis with bile plugs in the centrolobular area and Kupffer cell mobilization. Cholecystectomy, Roux en Y choledocho-jejunostomy was carried out following thorough irrigation of biliary tree. Patient was discharged on the 12th post-operative day uneventfully.
The patient did very well immediately following the discharge, with increased appetite and body weight. Four months after discharge, he developed substernal pain, right upper quadrant pain and indigestion. He was readmitted to the hospital in June 1965, 6 months following the discharge under the clinical impression of small intestinal adhesion due to previous surgery. Patient refused to have surgery and was discharged. However, he was readmitted two weeks later because of the increased pain and palpable mass in the upper abdominal wall. Re-exploratory laparatomy through the previous incision line revealed multiple nodular masses 1 ㎝-4.5 ㎝ in diameter throughout the liver surface, and these masses were infiltrating into the peritoneum and abdominal rectus muscle structures. The biopsy of the liver and the infiltrated abdominal rectus muscle was done. Patient was discharged on the 12th post-operative day without remarkable relief. The histologic examination of the specimen revealed primary carcinoma of liver characterized by atypical proliferation of lining cells of preexisted adenomatous hyperplasia of bile ducts, associated with irregular-sized glandular structures lined by flattened low columnar cells with hyperchromatic nuclei, atypical mitotic figures, piling-up of cells, edematous, myxoid and abundant stroma, and invasion into the preserved surrounding hepatic tissue. These gross and microscopic findings indicated very strongly that the pre-existed clonorchiasis sinensis transformed to primary carcinoma of liver(cholangiocellular carcinoma).
This case resembles closely to the cases reported by Dr. Hou in Hongkong. Further intensive clinical research is necessary to clarify the carcinogenesis of clonorchis sinensis. Our case reported here strongly indicate the possibility that the clonorhiasis may have induced primary carcinoma of liver in Korea.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|