A 65-year-old woman presents to the emergency department with persistent right upper quadrant pain with nausea and vomiting. CT of the abdomen reveals a polypoid mass of the gallbladder protruding into the lumen, diffuse thickening of the gallbladder wall, and enlarged lymph nodes. This patient most likely has a history of which of the following?
一名65岁女性因持续性右上腹疼痛伴恶心呕吐到急诊科就诊。腹部CT显示胆囊息肉样肿块突入胆囊腔内,胆囊壁弥漫性增厚,淋巴结肿大。该患者很可能有以下哪一种病史?
(A) Ascaris lumbricoides 蛔虫
(B) Cigarette smoking 吸烟
(C) Gallstones 胆结石
(D) Schistosoma haematobium 埃及血吸虫
(E) Tuberculosis 结核病
答案解析:
患者的临床表现符合胆囊腺癌。胆囊腺癌与胆囊慢性炎症有关,通常与胆囊结石病史有关,在CT上可见胆囊壁增厚。胆囊息肉,即息肉样病变,也与胆囊腺癌的风险增加相关。肿大的淋巴结表明局部侵犯和扩散,不幸的是,这在初次就诊时很常见。胆囊癌是一种中老年疾病,女性多于男性。大多数(90%)胆囊癌患者伴有结石。一般来说,胆囊腺癌的治疗是手术切除,但如果不是偶然发现,预后一般较差。
正确答案:C
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