Tsuchiya Y, Suzuki S, Sakaguchi T, Kojima Y, Okamoto K, Kurachi K, Konno H, Baba S, Nakamura S
Department of Surgery II, Hamamatsu University School of Medicine, Japan.
Surg Today. 2000;30(9):856-60. doi: 10.1007/s005950070074.
An extremely rare case of a lymphoepithelial cyst (LEC) of the pancreas is described herein. A pancreatic cystic tumor was initially detected in a 50-year-old man at a medical checkup. On admission, his serum carbohydrate antigen (CA) 19-9 level was 8100 U/ml and a computed tomography scan revealed a well-circumscribed multilocular cystic tumor in the pancreatic head and body. Magnetic resonance cholangiopancreatography showed no communication between the pancreatic ducts and the tumor. A distal pancreatectomy with lymph node dissection was performed because the lesion was suspected to be a mucinous cystadenoma or cystadenocarcinoma of the pancreas. However, histological examination revealed that the cyst was lined by stratified squamous epithelium and surrounded by lymphoid tissue. thereby confirming the diagnosis of LEC of the pancreas. The superficial layer of squamous epithelium and the cystic contents were found to be immunohistologically positive for CA19-9. Establishing a preoperative diagnosis of LEC is quite difficult because it resembles other cystic neoplasms of the pancreas in radiographic features and is frequently associated with an elevation of serum tumor markers such as CA19-9.
本文描述了一例极其罕见的胰腺淋巴上皮囊肿（LEC）病例。一名50岁男性在体检时首次发现胰腺囊性肿瘤。入院时，他的血清糖类抗原（CA）19-9水平为8100 U/ml，计算机断层扫描显示胰头和胰体有一个边界清晰的多房性囊性肿瘤。磁共振胰胆管造影显示胰管与肿瘤之间无连通。由于怀疑病变为胰腺黏液性囊腺瘤或囊腺癌，遂行远端胰腺切除术并清扫淋巴结。然而，组织学检查显示囊肿内衬复层鳞状上皮，周围有淋巴组织。从而确诊为胰腺LEC。鳞状上皮表层和囊内容物经免疫组织化学检测发现CA19-9呈阳性。术前诊断LEC相当困难，因为其在影像学特征上与胰腺其他囊性肿瘤相似，且常伴有血清肿瘤标志物如CA19-9升高。
