Adsay N V, Klimstra D S
Department of Pathology, The Karmanos Cancer Institute, Harper Hospital, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Semin Diagn Pathol. 2000 Feb;17(1):81-8.
In addition to the well-known cystic lesions, the differential diagnosis of pancreatic cysts also includes cystic counterparts (or cystic change in) otherwise typically solid tumors of this organ. Pancreatic endocrine neoplasms (islet cell tumors) and ductal adenocarcinomas sometimes undergo cystic degeneration, the latter usually due to necrosis. Also, although acinar cell carcinoma is typically a solid tumor, its rare cystic counterpart, "acinar cell cystadenocarcinoma," has been reported. A rare variant of pancreatic ductal adenocarcinoma referred to as "large-duct-type" is characterized by microcystic ectasia of the invasive glands and may mimic other cystic tumors at the microscopic level. Secondary tumors, although exceedingly rare, may also potentially fall into the differential diagnosis of pancreatic cysts. Often, the morphological characteristics of these lesions are identical to those of their solid counterparts, and their diagnosis is not difficult if one is aware of their existence. This review focuses on these cystic counterparts of otherwise characteristically solid pancreatic neoplasms. Solid pseudopapillary tumor, in which cystic degeneration is so common that "cystic" has been a part of many alternate terms assigned to this neoplasm, is discussed in another article of this issue of Seminars in Diagnostic Pathology.
除了众所周知的囊性病变外，胰腺囊肿的鉴别诊断还包括该器官其他通常为实性肿瘤的囊性对应物（或囊性改变）。胰腺内分泌肿瘤（胰岛细胞瘤）和导管腺癌有时会发生囊性退变，后者通常是由于坏死所致。此外，尽管腺泡细胞癌通常是实性肿瘤，但已报道过其罕见的囊性对应物“腺泡细胞囊腺癌”。一种称为“大导管型”的罕见胰腺导管腺癌变体，其特征是浸润性腺管的微囊性扩张，在显微镜下可能类似其他囊性肿瘤。继发性肿瘤虽然极为罕见，但也可能纳入胰腺囊肿的鉴别诊断。通常，这些病变的形态特征与其实性对应物相同，如果了解其存在，诊断并不困难。本综述重点关注这些通常为实性的胰腺肿瘤的囊性对应物。实性假乳头状肿瘤中囊性退变非常常见，以至于“囊性”已成为许多用于命名该肿瘤的替代术语的一部分，将在本期《诊断病理学研讨会》的另一篇文章中进行讨论。
