リンパ節転移を伴った十二指腸原発gangliocytic paragangliomaの1例
症例は十二指腸乳頭部腫瘍が指摘された50歳の女性で，生検にてneuroendocrine tumorが疑われた．腹部造影CTでは十二指腸下行脚内腔に突出する腫瘍に加えて水平脚腸管から壁外性進展の疑われる腫瘍性病変を認めたため，十二指腸neuroendocrine tumorと十二指腸消化管間葉系腫瘍疑いとの術前診断で手術を施行した．術中所見では後者は，腸間膜リンパ節転移が疑われたため，膵頭十二指腸切除術で一括切除した．病理組織学的検査では，乳頭部腫瘍内にneuroendocrine tumorとganglioneuromaの混合腫瘍の所見を認め，gangliocytic paraganglio...
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| Published in | 日本消化器外科学会雑誌 Vol. 48; no. 12; pp. 984 - 992 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本消化器外科学会
2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2014.0207 |
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| Abstract | 症例は十二指腸乳頭部腫瘍が指摘された50歳の女性で，生検にてneuroendocrine tumorが疑われた．腹部造影CTでは十二指腸下行脚内腔に突出する腫瘍に加えて水平脚腸管から壁外性進展の疑われる腫瘍性病変を認めたため，十二指腸neuroendocrine tumorと十二指腸消化管間葉系腫瘍疑いとの術前診断で手術を施行した．術中所見では後者は，腸間膜リンパ節転移が疑われたため，膵頭十二指腸切除術で一括切除した．病理組織学的検査では，乳頭部腫瘍内にneuroendocrine tumorとganglioneuromaの混合腫瘍の所見を認め，gangliocytic paragangliomaと診断された．また，腸間膜内腫瘍は同腫瘍のリンパ節転移と診断された．リンパ節転移を伴うgangliocytic paragangliomaは極めてまれなため報告する． |
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| AbstractList | 症例は十二指腸乳頭部腫瘍が指摘された50歳の女性で，生検にてneuroendocrine tumorが疑われた．腹部造影CTでは十二指腸下行脚内腔に突出する腫瘍に加えて水平脚腸管から壁外性進展の疑われる腫瘍性病変を認めたため，十二指腸neuroendocrine tumorと十二指腸消化管間葉系腫瘍疑いとの術前診断で手術を施行した．術中所見では後者は，腸間膜リンパ節転移が疑われたため，膵頭十二指腸切除術で一括切除した．病理組織学的検査では，乳頭部腫瘍内にneuroendocrine tumorとganglioneuromaの混合腫瘍の所見を認め，gangliocytic paragangliomaと診断された．また，腸間膜内腫瘍は同腫瘍のリンパ節転移と診断された．リンパ節転移を伴うgangliocytic paragangliomaは極めてまれなため報告する． |
| Author | 石戸, 圭之輔 鍵谷, 卓司 木村, 俊郎 袴田, 健一 工藤, 大輔 櫻庭, 伸悟 鬼島, 宏 豊木, 嘉一 木村, 憲央 吉澤, 忠司 |
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| References | 17) Ogata S, Horio T, Sugiura Y, Aiko S, Aida S. Duodenal gangliocytic paraganglioma with regional lymph node metastasis and a glandular component. Pathol Int. 2011 Feb;9:104–107. 13) 内田 大輔，小川 恒由，植木 亨，小南 陽子，沼田 紀史，松下 浩志，ほか．十二指腸gangliocytic paragangliomaの1例～本邦報告例の検討～．日本消化器病学会雑誌．2010;107:1456–1465. 10) Wong A, Miller AR, Metter J, Thomas CR Jr. Locally advanced duodenal gangliocytic paraganglioma treated with adjuvant radiation therapy: case report and review of the literature. World J Surg Oncol. 2005 Mar;3:15. 8) Sundararajan V, Robinson-Smith TM, Lowy AM. Duodenal gangliocytic paraganglioma with lymph node metastasis: a case report and review of the literature. Arch Pathol Lab Med. 2003 Mar;127:139–141. 4) Hashimoto S, Kawasaki S, Matsuzawa K, Harada H, Makuuchi M. Gangliocytic paraganglioma of the papilla of Vater with regional lymph node metastasis. Am J Gastroenterol. 1992 Sep;87:1216–1218. 19) Barret M, Rahmi G, Duong van Huyen JP, Landi B, Cellier C, Berger A. Duodenal gangliocytic paraganglioma with lymph node metastasis and an 8-year follow-up: a case report. Eur J Gastroenterol Hepatol. 2012 Jan;9:90–94. 1) Dahl EV, Waugh JM, Dahlin DC. Gastrointestinal ganglioneuromas, brief review with report of a duodenal ganglioneuroma. Am J Pathol. 1957 Sep–Oct;33:953–965. 2) Büchler M, Malfertheiner P, Baczako K, Krautzberger W, Beger HG. A metastatic endocrine-neurogenic tumor of the ampulla of Vater with multiple endocrine immunoreactions-malignant paraganglioma? Digestion. 1985;31:54–59. 11) Witkiewicz A, Galler A, Yeo CJ, Gross SD. Gangliocytic paraganglioma: case report and review of the literature. J Gastrointest Surg. 2007 Oct;11:1351–1354. 9) Bucher P, Mathe Z, Bühler L, Chilcott M, Gervaz P, Egger JF, et al. Paraganglioma of the ampulla of Vater: a potentially malignant neoplasm. Scand J Gastroenterol. 2004 Mar;39:291–295. 7) Tomic S, Warner T. Pancreatic somatostatin-secreting gangliocytic paraganglioma with lymph node metastases. Am J Gastroenterol. 1996 Mar;91:607–608. 3) Inai K, Kobuke T, Yonehara S, Tokuoka S. Duodenal gangliocytic paraganglioma showing lymph node metastasis in a 17-year-old boy. Cancer. 1989 Jun;63:2540–2545. 15) 斉藤 純子，平田 信人，古園 巳俊，中路 聡，稲瀬 誠実，長野 寛史，ほか．リンパ節転移をきたした十二指腸Gangliocytic paragangliomaの1例．日本消化器病学会雑誌．2010 Apr;107:639–648. 23) 杉浦 謙典，鈴木 大亮，秋山 貴洋，宮崎 勝．十二指腸乳頭部gangliocytic paragangliomaの1例．日本臨床外科学会雑誌．2012;73:346–352. 28) Scheithauer BW, Nora FE, LeChago J, Wick MR, Crawford BG, Weiland LH. Duodenal gangliocytic paraganglioma. Clinicopathologic and immunocytochemical study of 11 cases. Am J Clin Pathol. 1986 Nov;86:559–565. 5) 高林 直記，木村 泰三，吉田 雅行，桜町 俊二，原田 幸雄，喜納 勇．リンパ節転移を伴った十二指腸gangliocytic paragangliomaの1例．日本消化器外科学会雑誌．1993;26:2444–2448. 27) Perrone T, Sibley RK, Rosai J. Duodenal gangliocytic paraganglioma, an immunohistochemical and ultrastructural study and a hypothesis concerning its origin. Am J Surg Pathol. 1985 Jan; 9:31–41. 22) Okubo Y, Wakayama M, Nemoto T, Kitahara K, Nakayama H, Shibuya K, et al. Literature survey on epidemiology and pathology of gangliocytic paraganglioma. BMC Cancer. 2011 May;11:187. 6) Dookhan DB, Miettinen M, Finkel G, Gibas Z. Recurrent duodenal gangliocytic paraganglioma with lymph node metastases. Histopathology. 1993 Apr;22:399–401. 21) 日本膵臓学会編．膵癌取扱い規約 第6版補訂版．東京：金原出版；2013. 57 p. 14) Okubo Y, Yokose T, Tuchiya M, Mituda A, Wakayama M, Hasegawa C, et al. Duodenal gangliocytic paraganglioma showing lymph node metastasis: a rare case report. Diagn Pathol. 2010 May;5:27. 26) Burke AP, Helwig EB. Gangliocytic paraganglioma. Am J Clin Pathol. 1989 Jul;92:1–9. 30) Bukovsky A, Caudle MR, Svetlikova M. Steroid-mediated differentiation of neural/neuronal cells from epithelial ovarian precursors in vitro. Cell Cycle. 2008 Nov;7:3577–3583. 16) Rowsell C, Coburn N, Chetty R. Gangliocytic paraganglioma: a rare case with metastases of all 3 elements to liver and lymph nodes. Ann Diagn Pathol. 2011 Dec;15(6):467–471. 24) Jensen RT, Rindi G, Arnold R, Lopes JM, Brandi ML, Bechstein WO, et al. Well-differentiated duodenal tumor/carcinoma (excluding gastrinomas). Neuroendocrinology. 2006;84:165–172. 31) Liu L, Wang J, Zhao L, Nilsen J, McClure K, Wong K, et al. Progesterone increases rat neural progenitor cell cycle gene expression and proliferation via extracellularly regulated kinase and progesterone receptor membrane components 1 and 2. Endocrinology. 2009 Jul;150:3186–3196. 32) Parini U, Nardi M Jr, Loffredo A, Fabozzi M, Roveroni M. Laparoscopic resection of duodenal gangliocytic paraganglioma. A case report. Chir Ital. 2007 Jul–Aug;59:551–558. 20) Amin SM, Albrechtsen NW, Forster J, Damjanov I. Gangliocytic paraganglioma of duodenum metastatic to lymph nodes and liver and extending into the retropancreatic space. Pathologica. 2013 Jun;105(3):90–93. 12) Mann CM, Bramhall SR, Buckels JA, Taniere P. An unusual case of duodenal obstruction-gangliocytic paraganglioma. J Hepatobiliary Pancreat Surg. 2009 Jun;16:562–565. 18) Fiscaletti M, Fornelli A, Zanini N, Fabbri C, Collina G, Lega S, et al. Segmental groove pancreatitis and duodenal gangliocytic paraganglioma with lymph node metastasis: a newly described association. Pancreas. 2011 Oct;40(7):1145–1147. 29) Henry C, Ghalel-Mechaoui H, Bottero N, Pradier T, Moindrot H. Gangliocytic paraganglioma of the pancreas with bone metastasis. Ann Chir. 2003 Jun;128:336–338. 25) Klöppel G, Perren A, Heitz PU. The Gastroenteropancreatic neuroendocrine cell system and its tumors. The WHO classification. Ann N Y Acad Sci. 2004;1014:13–27. |
| References_xml | – reference: 26) Burke AP, Helwig EB. Gangliocytic paraganglioma. Am J Clin Pathol. 1989 Jul;92:1–9. – reference: 25) Klöppel G, Perren A, Heitz PU. The Gastroenteropancreatic neuroendocrine cell system and its tumors. The WHO classification. Ann N Y Acad Sci. 2004;1014:13–27. – reference: 24) Jensen RT, Rindi G, Arnold R, Lopes JM, Brandi ML, Bechstein WO, et al. Well-differentiated duodenal tumor/carcinoma (excluding gastrinomas). Neuroendocrinology. 2006;84:165–172. – reference: 32) Parini U, Nardi M Jr, Loffredo A, Fabozzi M, Roveroni M. Laparoscopic resection of duodenal gangliocytic paraganglioma. A case report. Chir Ital. 2007 Jul–Aug;59:551–558. – reference: 13) 内田 大輔，小川 恒由，植木 亨，小南 陽子，沼田 紀史，松下 浩志，ほか．十二指腸gangliocytic paragangliomaの1例～本邦報告例の検討～．日本消化器病学会雑誌．2010;107:1456–1465. – reference: 16) Rowsell C, Coburn N, Chetty R. Gangliocytic paraganglioma: a rare case with metastases of all 3 elements to liver and lymph nodes. Ann Diagn Pathol. 2011 Dec;15(6):467–471. – reference: 14) Okubo Y, Yokose T, Tuchiya M, Mituda A, Wakayama M, Hasegawa C, et al. Duodenal gangliocytic paraganglioma showing lymph node metastasis: a rare case report. Diagn Pathol. 2010 May;5:27. – reference: 4) Hashimoto S, Kawasaki S, Matsuzawa K, Harada H, Makuuchi M. Gangliocytic paraganglioma of the papilla of Vater with regional lymph node metastasis. Am J Gastroenterol. 1992 Sep;87:1216–1218. – reference: 17) Ogata S, Horio T, Sugiura Y, Aiko S, Aida S. Duodenal gangliocytic paraganglioma with regional lymph node metastasis and a glandular component. Pathol Int. 2011 Feb;9:104–107. – reference: 20) Amin SM, Albrechtsen NW, Forster J, Damjanov I. Gangliocytic paraganglioma of duodenum metastatic to lymph nodes and liver and extending into the retropancreatic space. Pathologica. 2013 Jun;105(3):90–93. – reference: 15) 斉藤 純子，平田 信人，古園 巳俊，中路 聡，稲瀬 誠実，長野 寛史，ほか．リンパ節転移をきたした十二指腸Gangliocytic paragangliomaの1例．日本消化器病学会雑誌．2010 Apr;107:639–648. – reference: 10) Wong A, Miller AR, Metter J, Thomas CR Jr. Locally advanced duodenal gangliocytic paraganglioma treated with adjuvant radiation therapy: case report and review of the literature. World J Surg Oncol. 2005 Mar;3:15. – reference: 3) Inai K, Kobuke T, Yonehara S, Tokuoka S. Duodenal gangliocytic paraganglioma showing lymph node metastasis in a 17-year-old boy. Cancer. 1989 Jun;63:2540–2545. – reference: 9) Bucher P, Mathe Z, Bühler L, Chilcott M, Gervaz P, Egger JF, et al. Paraganglioma of the ampulla of Vater: a potentially malignant neoplasm. Scand J Gastroenterol. 2004 Mar;39:291–295. – reference: 22) Okubo Y, Wakayama M, Nemoto T, Kitahara K, Nakayama H, Shibuya K, et al. Literature survey on epidemiology and pathology of gangliocytic paraganglioma. BMC Cancer. 2011 May;11:187. – reference: 2) Büchler M, Malfertheiner P, Baczako K, Krautzberger W, Beger HG. A metastatic endocrine-neurogenic tumor of the ampulla of Vater with multiple endocrine immunoreactions-malignant paraganglioma? Digestion. 1985;31:54–59. – reference: 23) 杉浦 謙典，鈴木 大亮，秋山 貴洋，宮崎 勝．十二指腸乳頭部gangliocytic paragangliomaの1例．日本臨床外科学会雑誌．2012;73:346–352. – reference: 7) Tomic S, Warner T. Pancreatic somatostatin-secreting gangliocytic paraganglioma with lymph node metastases. Am J Gastroenterol. 1996 Mar;91:607–608. – reference: 6) Dookhan DB, Miettinen M, Finkel G, Gibas Z. Recurrent duodenal gangliocytic paraganglioma with lymph node metastases. Histopathology. 1993 Apr;22:399–401. – reference: 1) Dahl EV, Waugh JM, Dahlin DC. Gastrointestinal ganglioneuromas, brief review with report of a duodenal ganglioneuroma. Am J Pathol. 1957 Sep–Oct;33:953–965. – reference: 11) Witkiewicz A, Galler A, Yeo CJ, Gross SD. Gangliocytic paraganglioma: case report and review of the literature. J Gastrointest Surg. 2007 Oct;11:1351–1354. – reference: 28) Scheithauer BW, Nora FE, LeChago J, Wick MR, Crawford BG, Weiland LH. Duodenal gangliocytic paraganglioma. Clinicopathologic and immunocytochemical study of 11 cases. Am J Clin Pathol. 1986 Nov;86:559–565. – reference: 30) Bukovsky A, Caudle MR, Svetlikova M. Steroid-mediated differentiation of neural/neuronal cells from epithelial ovarian precursors in vitro. Cell Cycle. 2008 Nov;7:3577–3583. – reference: 27) Perrone T, Sibley RK, Rosai J. Duodenal gangliocytic paraganglioma, an immunohistochemical and ultrastructural study and a hypothesis concerning its origin. Am J Surg Pathol. 1985 Jan; 9:31–41. – reference: 21) 日本膵臓学会編．膵癌取扱い規約 第6版補訂版．東京：金原出版；2013. 57 p. – reference: 18) Fiscaletti M, Fornelli A, Zanini N, Fabbri C, Collina G, Lega S, et al. Segmental groove pancreatitis and duodenal gangliocytic paraganglioma with lymph node metastasis: a newly described association. Pancreas. 2011 Oct;40(7):1145–1147. – reference: 31) Liu L, Wang J, Zhao L, Nilsen J, McClure K, Wong K, et al. Progesterone increases rat neural progenitor cell cycle gene expression and proliferation via extracellularly regulated kinase and progesterone receptor membrane components 1 and 2. Endocrinology. 2009 Jul;150:3186–3196. – reference: 12) Mann CM, Bramhall SR, Buckels JA, Taniere P. An unusual case of duodenal obstruction-gangliocytic paraganglioma. J Hepatobiliary Pancreat Surg. 2009 Jun;16:562–565. – reference: 5) 高林 直記，木村 泰三，吉田 雅行，桜町 俊二，原田 幸雄，喜納 勇．リンパ節転移を伴った十二指腸gangliocytic paragangliomaの1例．日本消化器外科学会雑誌．1993;26:2444–2448. – reference: 8) Sundararajan V, Robinson-Smith TM, Lowy AM. Duodenal gangliocytic paraganglioma with lymph node metastasis: a case report and review of the literature. Arch Pathol Lab Med. 2003 Mar;127:139–141. – reference: 19) Barret M, Rahmi G, Duong van Huyen JP, Landi B, Cellier C, Berger A. Duodenal gangliocytic paraganglioma with lymph node metastasis and an 8-year follow-up: a case report. Eur J Gastroenterol Hepatol. 2012 Jan;9:90–94. – reference: 29) Henry C, Ghalel-Mechaoui H, Bottero N, Pradier T, Moindrot H. Gangliocytic paraganglioma of the pancreas with bone metastasis. Ann Chir. 2003 Jun;128:336–338. |
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| Snippet | 症例は十二指腸乳頭部腫瘍が指摘された50歳の女性で，生検にてneuroendocrine tumorが疑われた．腹部造影CTでは十二指腸下行脚内腔に突出する腫瘍に加えて水平脚腸管から壁外性進展の疑われる腫瘍性病変を認めたため，十二指腸neuroendocrine... |
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| Title | リンパ節転移を伴った十二指腸原発gangliocytic paragangliomaの1例 |
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| ispartofPNX | 日本消化器外科学会雑誌, 2015/12/01, Vol.48(12), pp.984-992 |
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