Muramatsu T, Kijima H, Tsuchida T, Konagaya M, Matsubayashi H, Tada N, Nakamura M, Ueyama Y
Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
J Clin Gastroenterol. 2000 Sep;31(2):175-8. doi: 10.1097/00004836-200009000-00020.
An unusual case of malignant pancreatic composite tumor with both components of acinar cell tumor (ACT) and islet cell tumor (ICT) was investigated histologically, immunohistochemically, and ultrastructurally. The pancreatic tumor with central cyst formation was found on computerized tomographic examination of a 72-year-old man reporting appetite and weight loss. The ACT component was present in the original pancreatic region and the ICT region was adjacent to the ACT. ACT was immunohistochemically positive for pancreatic amylase, whereas ICT had argyrophil tumor cells immunohistochemically positive for chromogranin A. There were several tumor cell nests positive for both pancreatic amylase (acinar differentiation) and chromogranin A (islet differentiation). We speculated that ICT may have arisen from the de-differentiated tumor cells in the ACT after the occurrence of ACT.
对一例罕见的同时具有腺泡细胞肿瘤（ACT）和胰岛细胞瘤（ICT）两种成分的恶性胰腺复合肿瘤进行了组织学、免疫组织化学和超微结构研究。在对一名报告有食欲减退和体重减轻的72岁男性进行计算机断层扫描检查时，发现胰腺肿瘤有中央囊肿形成。ACT成分位于胰腺原发病灶区域，ICT区域与ACT相邻。ACT免疫组织化学检测胰腺淀粉酶呈阳性，而ICT的嗜银肿瘤细胞免疫组织化学检测嗜铬粒蛋白A呈阳性。有几个肿瘤细胞巢同时对胰腺淀粉酶（腺泡分化）和嗜铬粒蛋白A（胰岛分化）呈阳性。我们推测ICT可能是在ACT发生后由ACT中去分化的肿瘤细胞产生的。
