Nakamura S, Okayama Y, Imai H, Aoki S, Kobayashi S, Hattori T, Shiraki S, Goto K, Sano H, Ohara H, Nomura T, Joh T, Yoshifumi Y, Itoh M
Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Gifu, Japan.
J Clin Gastroenterol. 2001 Oct;33(4):333-6. doi: 10.1097/00004836-200110000-00017.
We report the case of a 34-year-old woman with a solid cystic tumor (SCT) of the pancreas accompanied by ossification and possible malignancy, coexisting nonfusion of the pancreatic ducts. There was a 24 x 29 x 33-mm mass with a prominent calcified lesion in the tail of the pancreas detected by abdominal ultrasonography, computed tomography, and magnetic resonance imaging. There were no distal metastases detected. Endoscopic retrograde pancreatography revealed nonfusion of the pancreatic ducts. The resected tumor consisted of solid and cystic components. The tumor was not encapsulated and included a severely ossified lesion inside. On microscopy, the tumor cells were small, eosinophilic, and proliferated in a solid or pseudo-papillary pattern. The tumor cells infiltrated into the surrounding normal pancreas parenchyma and invaded part of the mesentery. The immunostaining was positive for alpha-1-antitrypsin, neuron-specific enolase, vimentin, and chromogranin A. In the literature, only a few cases of SCT of the pancreas described ossification. As far as we know, only three cases of SCT of the pancreas, which demonstrated nonfusion of the pancreatic ducts, have been reported. Thus, SCT of the pancreas with ossification, possible malignancy, and coexisting nonfusion of the pancreatic ducts is extremely rare.
我们报告了一例34岁女性患者，其胰腺存在实性囊性肿瘤（SCT），伴有骨化且可能为恶性，同时存在胰管未融合的情况。通过腹部超声、计算机断层扫描和磁共振成像检查，在胰腺尾部发现了一个大小为24×29×33毫米的肿块，伴有一个明显的钙化病变。未检测到远处转移。内镜逆行胰胆管造影显示胰管未融合。切除的肿瘤由实性和囊性成分组成。肿瘤无包膜，内部有严重的骨化病变。显微镜下，肿瘤细胞小，嗜酸性，呈实性或假乳头状增殖。肿瘤细胞浸润到周围正常胰腺实质，并侵犯了部分肠系膜。免疫组化显示α-1抗胰蛋白酶、神经元特异性烯醇化酶、波形蛋白和嗜铬粒蛋白A呈阳性。在文献中，仅有少数胰腺SCT病例描述了骨化情况。据我们所知，仅有三例胰腺SCT病例报告显示存在胰管未融合。因此，伴有骨化、可能为恶性且同时存在胰管未融合的胰腺SCT极为罕见。
