Takase M, Suda K
Department of Pathology, Juntendo University School of Medicine, Tokyo, Japan.
Pathol Int. 2001 May;51(5):349-54. doi: 10.1046/j.1440-1827.2001.01215.x.
Fifteen cases of tumor-forming pancreatitis, detected as tumors by diagnostic imaging or by physical examination were histologically examined. Eleven of the 15 patients were heavy drinkers. Tumorous lesions were located in the head of the pancreas in 11 cases and in the body or tail of the pancreas in four cases. Macroscopic examination revealed tumorous swelling or sclerotic appearance in the pancreatic tissue. Histologically, these lesions showed tumorous swelling with (n = 12) or without (n = 3) a background of chronic pancreatitis. In the former, the tumorous lesions consisted of extensive fibrosis, including necrosis or abscesses, stones and reparative granulation tissue, and there was a successive transition to the surrounding chronic pancreatitis pattern. The latter three tumorous lesions presented with inter- and intralobular fibrosis with lymphoid hyperplasia or lymphoplasmacytic infiltration and were adjacent to normal pancreatic tissue. Therefore, tumor-forming pancreatitis shows at least two distinct types: a reparative tumorous swelling with a background of chronic pancreatitis, which is considered to have given rise to the tumor at some stage; and a lymphoid and fibrous proliferation in normal pancreatic tissue, which is considered to represent an autoimmune-related disease process.
对15例经诊断性影像学检查或体格检查发现为肿瘤的肿瘤样胰腺炎病例进行了组织学检查。15例患者中有11例为重度饮酒者。肿瘤性病变位于胰头11例，位于胰体或胰尾4例。宏观检查显示胰腺组织有肿瘤样肿胀或硬化外观。组织学上，这些病变表现为伴有（n = 12）或不伴有（n = 3）慢性胰腺炎背景的肿瘤样肿胀。在前一种情况下，肿瘤性病变由广泛的纤维化组成，包括坏死或脓肿、结石和修复性肉芽组织，并且与周围慢性胰腺炎模式有连续过渡。后三种肿瘤性病变表现为小叶间和小叶内纤维化伴淋巴细胞增生或淋巴浆细胞浸润，且与正常胰腺组织相邻。因此，肿瘤样胰腺炎至少表现为两种不同类型：一种是以慢性胰腺炎为背景的修复性肿瘤样肿胀，被认为在某个阶段引发了肿瘤；另一种是正常胰腺组织中的淋巴样和纤维增生，被认为代表一种自身免疫相关的疾病过程。
