Kimura W, Futakawa N, Zhao B, Wada Y
First Department of Surgery, Yamagata University School of Medicine, 2-2-2 Iida-Nishi Yamagata City, Yamagata 990-9585, Japan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):273-6.
A 62-year-old man had complained of left abdominal pain and tenderness and a body weight loss. Abdominal ultrasonography and computed tomography revealed homogeneous tumor with clear margin, and an irregular shape (3.5 x 2.0 cm) in the body of the pancreas. Endoscopic retrograde cholangiopancreatography showed a shadow defect in the main pancreatic duct adjacent to the tumor, which suggested intraductal tumor spread. Distal pancreatectomy with splenectomy and left paraaortic lymph node dissection was performed. Microscopically, the tumor showed microtubular carcinoma, which was characterized by a cribriform pattern, medullary growth, and little interstitium. The tumor was encapsulated by a relatively thick fibrous capsule. The patient was discharged uneventfully, and he is alive 33 months after operation without a distinct sign of recurrence. In conclusion, cribriform carcinoma of the pancreas has specific characteristics, such as good prognosis, expansive growth with little invasion, intraductal growth and spread without mucin production and histological marked cribriform pattern. This type of carcinoma should be classified as a new disease entity of carcinoma of the pancreas.
一名62岁男性主诉左腹痛、压痛及体重减轻。腹部超声和计算机断层扫描显示胰腺体部有边界清晰、形态不规则（3.5×2.0 cm）的均匀肿瘤。内镜逆行胰胆管造影显示肿瘤附近主胰管有充盈缺损，提示肿瘤沿导管内扩散。行远端胰腺切除术、脾切除术及左腹主动脉旁淋巴结清扫术。显微镜下，肿瘤为微管癌，其特征为筛状结构、髓样生长及间质较少。肿瘤被相对较厚的纤维包膜包裹。患者术后顺利出院，术后33个月仍存活，无明显复发迹象。总之，胰腺筛状癌具有特定特征，如预后良好、生长方式为膨胀性且侵袭性小、沿导管内生长和扩散且不产生黏液以及组织学上有明显的筛状结构。这种类型的癌应归类为胰腺的一种新的疾病实体。
