女,55岁。右上腹痛渐重1个月,食少、消瘦,小便黄,大便灰白,体力下降,周身搔痒。查体:轻度黄疸。肝肋下5cm,质硬、表面光滑。B超示“胆囊癌”。手术:肝门区5×5cm包块,质硬、边界不清,与胃、肝动脉、门静脉广泛粘连。左、右肝管均见肿物。行肿块切除术。病理检查:黄色不整组织7×7×5cm,切面见裂隙状囊腔,内有少许泥砂样物。囊壁厚0.2～1cm,内壁粗糙。切面深黄色,质脆。镜下,肿瘤由腺癌和鳞癌两种成分混合构成。腺癌细胞呈柱状,排列成不规则 Female, 55 years old. The pain in the right upper quadrant gradually weighed for 1 month. It was eaten less, was wasted, urine was yellow, the stool was gray, the physical strength was decreased, and the body was itchy. Physical examination: mild jaundice. Liver ribs 5cm, hard, smooth surface. B ultrasound shows “gallbladder cancer.” Surgery: 5×5cm masses in the hilus area, hard and unclear borders, and extensive adhesions to the stomach, hepatic artery, and portal vein. Left and right hepatic ducts all showed tumors. Row lumpectomy. Pathological examination: The yellow tissue was not 7×7×5cm. The cut surface was seen in the fissure-like cyst with a little muddy material. Wall thickness 0.2 ~ 1cm, rough inner wall. The cut surface is dark yellow and crisp. Microscopically, the tumor consists of a mixture of adenocarcinoma and squamous cell carcinoma. Adenocarcinoma cells are columnar and arranged irregularly