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any of various air-filled cavities especially in the bones of the skull

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洞(どう)(骨や組織の中の穴・くぼみなど);静脈洞

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/03 13:03:21」(JST)

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Rokitansky–Aschoff sinuses, also entrapped epithelial crypts, are pseudodiverticula or pockets in the wall of the gallbladder. They may be microscopic or macroscopic.

Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer and subserosal tissue as a result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall. They are usually referred to as adenomyomatosis.^[1]

They are not of themselves considered abnormal, but they can be associated with cholecystitis.^[2]

Pathophysiology

They form as a result of increased pressure in the gallbladder and recurrent damage to the wall of the gallbladder.

Associations

Black pigment gallstones can form in Rokitansky-Aschoff sinuses of the gallbladder after the fourth to fifth decades of life in absence of the typical risk factors for bilirubin suprasaturation of bile.^[1] Hence, they are associated with gallstones (cholelithiasis). Cases of gall bladder cancer have also been reported to arise from Rokitansky–Aschoff sinuses.^[3]

Diagnosis

Since Rokitansky–Aschoff sinuses can be normally present in the gall badder without any pathology, the radiological detection of these is only of academic interest.^[4] Magnetic resonance imaging plays an important role in the diagnosis of Rokitansky–Aschoff sinuses.^[5]

Eponym

They are named after Carl Freiherr von Rokitansky (1804-1878), a pathologist in Vienna, Austria and Ludwig Aschoff (1866-1942), a pathologist in Bonn, Germany.^[6]^[7]

References

^ ^a ^b Cariati, A; Cetta, F (2002). "Rokitansky-Aschoff sinuses of the gallbladder are associated with black pigment gallstone formation: a scanning electron microscopy study.". Ultrastructural pathology 27 (4): 265–70. PMID 12907372.
^ van Breda Vriesman, AC; Engelbrecht, MR; Smithuis, RH; Puylaert, JB (February 2007). "Diffuse gallbladder wall thickening: differential diagnosis.". AJR. American journal of roentgenology 188 (2): 495–501. doi:10.2214/AJR.05.1712. PMID 17242260.
^ Matsumoto, T; Shimada, K (November 2009). "A case of gallbladder cancer arising from the Rokitansky-Aschoff sinus.". Japanese journal of clinical oncology 39 (11): 776. doi:10.1093/jjco/hyp149. PMID 19884193.
^ Sukman, R; Daron, PB (May 1953). "Roentgen visualization of the Rokitansky-Aschoff sinuses as an additional sign of chronic gallbladder disease.". Radiology 60 (5): 714–7. doi:10.1148/60.5.714. PMID 13056187.
^ Yoshimitsu, K; Honda, H; Jimi, M; Kuroiwa, T; Hanada, K; Irie, H; Tajima, T; Takashima, M; Chijiiwa, K; Shimada, M; Masuda, K (June 1999). "MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinuses.". AJR. American journal of roentgenology 172 (6): 1535–40. PMID 10350285.
^ synd/983 at Who Named It?
^ Kanne, JP; Rohrmann CA, Jr; Lichtenstein, JE (2005). "Eponyms in radiology of the digestive tract: historical perspectives and imaging appearances. Part 2. Liver, biliary system, pancreas, peritoneum, and systemic disease.". Radiographics : a review publication of the Radiological Society of North America, Inc 26 (2): 465–80. doi:10.1148/rg.262055130. PMID 16549610.

External links

00859 at CHORUS

Histology at University of Utah

UpToDate Contents

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1. 胆嚢ポリープおよびコレステロール沈着 gallbladder polyps and cholesterolosis
2. 黄色肉芽腫性胆嚢炎 xanthogranulomatous cholecystitis

English Journal

Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies.

Terada T.SourceDepartment of Pathology, Shizuoka City Shimizu Hospital Shizuoka, Japan. piyo0111jp@yahoo.co.jp
International journal of clinical and experimental pathology.Int J Clin Exp Pathol.2013;6(1):91-6. Epub 2012 Nov 20.
The frequency of gall bladder lesions in cholecystectomies is not clear. The purpose of the present study is to report the morphologies and frequency of gall bladder diseases and lesions of 540 cholecystectomies in the last 10 years in our pathology laboratory. The age of patients ranged from 18 yea
PMID 23236547

Pathologic staging of pancreatic, ampullary, biliary, and gallbladder cancers: pitfalls and practical limitations of the current AJCC/UICC TNM staging system and opportunities for improvement.

Adsay NV, Bagci P, Tajiri T, Oliva I, Ohike N, Balci S, Gonzalez RS, Basturk O, Jang KT, Roa JC.SourceDepartment of Pathology, Emory University, School of Medicine, Atlanta, Georgia, USA. volkan.adsay@emory.edu
Seminars in diagnostic pathology.Semin Diagn Pathol.2012 Aug;29(3):127-41. doi: 10.1053/j.semdp.2012.08.010.
Tumors of the ampulla-pancreatobiliary tract are encountered increasingly; however, their staging can be highly challenging due to lack of familiarity. In this review article, the various issues encountered in staging of these tumors at the pathologic level are evaluated and possible solutions for d
PMID 23062420

Japanese Journal

臨床報告 Rokitansky-Aschoff洞内に発生した早期胆嚢癌の1例

平沼知加志,服部昌和,遠藤直樹 [他]
臨床外科 66(5), 667-670, 2011-05-00
NAID 40018817348

In situ adenocarcinoma of the gallbladder arising in Rokitansky-Aschoff sinuses of adenomyomatosis : A rare site of origin of gallbladder carcinoma

HANADA M
J Toyonaka Muni Hosp 6, 67-74, 2005
NAID 50006044197

小児期に発症し若年で胆嚢摘出術を施行した胆嚢腺筋腫症の1例

岡邨香織,石丸由紀,木崎義行,大谷祐之,高安肇,森吉臣,池田均
日本小児外科学会雑誌 40(5), 713-717, 2004-08-20
… ,精査目的で来院.腹部超音波検査で胆嚢壁のびまん性肥厚を認め,1年間の経過観察を行った後,症状が軽快しないため腹腔鏡下胆嚢摘出術を施行した.摘出胆嚢は壁の厚さが3mmから4mmで,組織学的にRokitansky-Aschoff洞のびまん性増殖と部分的な筋線維の増生を認め,びまん型の胆嚢腺筋腫症と診断した.術後経過は良好で,7ヵ月を経過し無症状である.本症は小児期に発症し外科的治療を必要とすることは稀で …
NAID 110002093548

Related Pictures

Chronic cholecystitis with Rokitansky Aschoff sinuses. | Download Scientific Diagram Rokitansky-Aschoff sinuses- herniation of mucosa into muscular wall seen in chronic Qiao's Pathology: Thickened Gallbladder Wall with Rokitans… | Flickr File:Rokitansky-Aschoff Sinus (7740084082).jpg - Wikimedia Commons Gallbladder: Rokitansky-Aschoff Sinus | Ed Uthman | Flickr

★リンクテーブル★

リンク元	「ロキタンスキー・アショフ洞」

「ロキタンスキー・アショフ洞」

Rokitansky–Aschoff sinuses
	Micrograph showing a Rokitansky–Aschoff sinus. H&E stain.
Classification and external resources
Specialty	gastroenterology
ICD-10	K82.8
ICD-9-CM	575.8

　　[★]

英: Rokitansky-Aschoff sinus RAS, Rokitansky-Aschoff sinuses
関: 胆嚢、胆嚢#壁構造、胆嚢憩室、腺筋腫症、ルシュカ管

胆嚢内腔と交通を有する粘膜上皮の壁内への憩室様陥入
粘膜上皮は筋層の中に陥凹、さらに漿膜下に達することがある。
胆嚢外に突出せず、胆嚢壁にとどまる。

臨床関連

胆嚢腺筋症

ロキタンスキー・アショフ洞

造影CTや胆嚢造影併用CTで壁内にRokitansly-Aschoff sinusの拡張が見られる

[pmid12907372-1] Cariati, A; Cetta, F (2002). "Rokitansky-Aschoff sinuses of the gallbladder are associated with black pigment gallstone formation: a scanning electron microscopy study.". Ultrastructural pathology 27 (4): 265–70. PMID 12907372.

[2] van Breda Vriesman, AC; Engelbrecht, MR; Smithuis, RH; Puylaert, JB (February 2007). "Diffuse gallbladder wall thickening: differential diagnosis.". AJR. American journal of roentgenology 188 (2): 495–501. doi:10.2214/AJR.05.1712. PMID 17242260.

[3] Matsumoto, T; Shimada, K (November 2009). "A case of gallbladder cancer arising from the Rokitansky-Aschoff sinus.". Japanese journal of clinical oncology 39 (11): 776. doi:10.1093/jjco/hyp149. PMID 19884193.

[4] Sukman, R; Daron, PB (May 1953). "Roentgen visualization of the Rokitansky-Aschoff sinuses as an additional sign of chronic gallbladder disease.". Radiology 60 (5): 714–7. doi:10.1148/60.5.714. PMID 13056187.

[pmid10350285-5] Yoshimitsu, K; Honda, H; Jimi, M; Kuroiwa, T; Hanada, K; Irie, H; Tajima, T; Takashima, M; Chijiiwa, K; Shimada, M; Masuda, K (June 1999). "MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinuses.". AJR. American journal of roentgenology 172 (6): 1535–40. PMID 10350285.

[6] synd/983 at Who Named It?

[7] Kanne, JP; Rohrmann CA, Jr; Lichtenstein, JE (2005). "Eponyms in radiology of the digestive tract: historical perspectives and imaging appearances. Part 2. Liver, biliary system, pancreas, peritoneum, and systemic disease.". Radiographics : a review publication of the Radiological Society of North America, Inc 26 (2): 465–80. doi:10.1148/rg.262055130. PMID 16549610.

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案内

Rokitansky-Aschoff sinuses