白浜 正文¹, 高橋 浩一郎¹, 岸川 圭嗣², 笹富 英三郎³, 宮本 祐一¹, 石橋 大海⁴

Masafumi SHIRAHAMA¹, Koichiro TAKAHASHI¹, Keiji KISHIKAWA², Eizaburo SASATOMI³, Yuichi MIYAMOTO¹, Hiromi ISHIBASHI⁴

¹佐賀県立病院好生館内科, ²佐賀県立病院好生館外科, ³佐賀県立病院好生館病理, ⁴九州大学医学部第1内科

¹Department of Internal Medicine, Saga Prefectural Hospital, ²Department of Surgery, Saga Prefectural Hospital, ³Department of Pathology, Saga Prefectural Hospital, ⁴First Department of Internal Medicine, Faculty of Medicine, Kyushu University

キーワード : Color Doppler ultrasonography, Early cancer, Gallbladder cancer

A 70-year-old man was admitted to the hospital because of an elevated lesion of the gallbladder (GB). Initial laboratory examination showed mild abnormality in liver function and slight hyperglycemia. Gray-scale ultrasonography (US) showed a small elevated lesion on a papillary surface at the fundus of the GB, and the adjacent GB wall was mildly thickened. Color Doppler US demonstrated several blood flow signals at the base of the elevated lesion, and the power Doppler mode detected the blood flow signals more sensitively, not only in the underlying GB wall but in the wall contiguous to the lesion as well. Color Doppler signals in the normal GB wall were invisible. Analysis of the Doppler waveform demonstrated arterial blood flow signals. A resected GB specimen showed papillary adenocarcinoma (early cancer) and dysplastic epithelium in the adjacent area. Immunostaining with factor Ⅷ showed the number of vessels in the GB wall to be the same at the base of the tumor as that in the area of the dysplastic or normal mucosa. Color Doppler and other US examinations seemed to be useful in the detection of early GB cancer.