Tobita K, Kijima H, Chino O, Dowaki S, Kashiwagi H, Tanaka M, Ohtani Y, Inokuchi S, Makuuchi H
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Anticancer Res. 2001 May-Jun;21(3C):2131-4.
The majority of pancreatic malignant tumors are adenocarcinomas of the ductal type (ductal cell carcinomas) and combined tumors consisting of different tumor components are very rare. We present here a rare case of acinar cell carcinoma with apparent foci of endocrine differentiation. A 46-year-old man underwent pylorus-preserving pancreatoduodenectomy under the diagnosis of pancreatic tumor. The pancreatic tumor was mainly composed of typical acinar cell carcinoma, but some tumor cells were positive for both acinar and endocrine cell markers such as pancreatic amylase, trypsin, lipase and chromogranin A. At the electron-microscopic level, the tumor cells were seen to have numerous electron-dense neuroendocrine, as well as a few zymogen-like, granules. The tumor part positive for both acinar and endocrine cell markers originated from a subclone (dis-differentiated tumor cells) of the typical acinar cell carcinoma tissue of the pancreas.
大多数胰腺恶性肿瘤是导管型腺癌（导管细胞癌），由不同肿瘤成分组成的复合肿瘤非常罕见。我们在此报告一例罕见的具有明显内分泌分化灶的腺泡细胞癌。一名46岁男性在诊断为胰腺肿瘤后接受了保留幽门的胰十二指肠切除术。胰腺肿瘤主要由典型的腺泡细胞癌组成，但一些肿瘤细胞对腺泡和内分泌细胞标志物均呈阳性，如胰淀粉酶、胰蛋白酶、脂肪酶和嗜铬粒蛋白A。在电子显微镜下，可见肿瘤细胞有大量电子致密的神经内分泌颗粒，以及一些酶原样颗粒。对腺泡和内分泌细胞标志物均呈阳性的肿瘤部分起源于胰腺典型腺泡细胞癌组织的一个亚克隆（去分化肿瘤细胞）。
