Colon signet-ring cell carcinoma with chylous ascites caused by immunosuppressants following liver transplantation:A case report  

作　　者：Ying Li Yang Tai Hao Wu 

机构地区：[1]Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第7期2343-2350,共8页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.82270649.

摘　　要：BACKGROUND Chylous ascites is caused by disruption of the lymphatic system,which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity.The two most common causes are cirrhosis and tuberculosis,and colon signer ring cell carcinoma(SRCC)due to the use of immunosuppressants is extremely rare in cirrhotic patients after liver transplantation,making it prone to misdiagnosis and missed diagnosis.CASE SUMMARY A 52-year-old man who underwent liver transplantation and was administered with immunosuppressants for 8 months was admitted with a 3-month history of progressive abdominal distention.Initially,based on lymphoscintigraphy and lymphangiography,lymphatic obstruction was considered,and cystellar chyli decompression with band lysis and external membrane stripping of the lymphatic duct was performed.However,his abdominal distention was persistent without resolution.Abdominal paracentesis revealed allogenic cells in the ascites,and immunohistochemistry analysis revealed adenocarcinoma cells with phenotypic features suggestive of a gastrointestinal origin.Gastrointestinal endoscopy was performed,and biopsy showed atypical signet ring cells in the ileocecal valve.The patient eventually died after a three-month follow-up due to progression of the tumor.CONCLUSION Colon SRCC,caused by immunosuppressants,is an unusual but un-neglected cause of chylous ascites.

关 键 词：Colonic signer ring cell carcinoma IMMUNOSUPPRESSANT Chylous ascites CIRRHOSIS Liver transplantation Case report 

分 类 号：R657.3[医药卫生—外科学] R73[医药卫生—临床医学]