Fukushima N, Mukai K
Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan.
Adv Anat Pathol. 1999 Mar;6(2):65-77. doi: 10.1097/00125480-199903000-00001.
The clinicopathologic features and problems in classification and diagnosis of the pancreatic neoplasms with abundant mucus production are presented. In this article, the various reported concepts and terminology of these mucus-producing pancreatic tumors are summarized, and the differences between intraductal papillary-mucinous tumors and mucinous cystic tumors are specifically discussed. Intraductal papillary-mucinous tumors show diffuse or segmental dilatation of the pancreatic ducts with intraductal papillary growth. Mucinous cystic tumors are mucus-producing tumors showing cyst formation, which is often accompanied by intracystic papillary projections and "ovarian-type" stroma. Intraductal papillary-mucinous tumors occur most often in the pancreatic head of elderly men, whereas mucinous cystic tumors typically occur in the pancreatic tail or body of middle-aged women. Histologically, these tumors show a wide cytologic spectrum from benign to borderline to malignant. These tumors pursue an indolent clinical course compared with conventional ductal carcinoma of the pancreas. Mucinous cystadenocarcinomas have a higher malignant potential than intraductal papillary-mucinous adenocarcinomas, yet these tumors recur infrequently if they are excised completely. Because of the differences in clinicopathologic features, these tumors should be clearly separated from conventional ductal carcinoma of the pancreas.
本文介绍了具有大量黏液分泌的胰腺肿瘤的临床病理特征以及分类和诊断方面的问题。文中总结了这些产生黏液的胰腺肿瘤的各种已报道概念和术语，并特别讨论了导管内乳头状黏液性肿瘤与黏液性囊性肿瘤之间的差异。导管内乳头状黏液性肿瘤表现为胰腺导管的弥漫性或节段性扩张及导管内乳头状生长。黏液性囊性肿瘤是产生黏液的肿瘤，表现为囊肿形成，常伴有囊内乳头状突起和“卵巢型”间质。导管内乳头状黏液性肿瘤最常发生于老年男性的胰头，而黏液性囊性肿瘤通常发生于中年女性的胰尾或胰体。组织学上，这些肿瘤呈现从良性到交界性再到恶性的广泛细胞学谱系。与胰腺导管腺癌相比，这些肿瘤的临床病程较为惰性。黏液性囊腺癌比导管内乳头状黏液腺癌具有更高的恶性潜能，但如果完全切除，这些肿瘤很少复发。由于临床病理特征的差异，这些肿瘤应与胰腺导管腺癌明确区分。
