Meng Y, Yu J, Kang X, Duan W, Zheng J, Yao L, Hu M, Yang D
Department of Pathology, Navy General Hospital, Beijing 100037.
Zhonghua Bing Li Xue Za Zhi. 1999 Dec;28(6):409-13.
To study the clinicopathologic characteristics, differentiation patterns and histogenesis of cystic and solid tumors of the pancreas (CSTP).
8 cases of CSTP were studied using histologic (HE and PAS), immunohistochemical (S-P method) and electron microscopic techniques.
All the patients were adolescent and young adult females, 14-33 years in age (mean 25.3 years) without recurrence after tumor resection. The mean diameter of tumors was 9.6 cm, all encapsulated. Histological examination showed presence of solid sheets, pseudopapillary, in all of the cases. Hemorrhage, foam cells, and cholesterol crystals were often found. Immunohistochemically, 8 cases were positive for alpha(1)-AT and lysozyme; 6 cases expressed vimentin, 2 cases expressed actin, and CgA-positive cells found in the tumor cell nests in one case. All of the cases showed PR, and 4 cases showed ER positive immunoreactivity in the majority of tumor cells, but negative for CK AE1, CK AE3, EMA, Synaptophysin, ACTH, gastrin, somatostatin, insulin, and glucogan in all the cases. Electron microscopy of 3 cases showed evidences of polymorphism in differentiation of the tumor cells, including the transitional appearance into ducts, acinus, and endocrine cells. Weibel-Palade body found in tumor cells in one out of 8 cases.
(1) CSTP is a distinct clinicopathologic entity in young female patients with a benign clinical course. (2) CSTP develops from primitive pancreatic cells, with the potentiality of developing into ducts, acinus, and endocrine cells.
研究胰腺囊实性肿瘤(CSTP)的临床病理特征、分化模式及组织发生。
采用组织学(HE和PAS)、免疫组织化学(S-P法)及电子显微镜技术对8例CSTP进行研究。
所有患者均为青春期及青年女性,年龄14 - 33岁(平均25.3岁),肿瘤切除后无复发。肿瘤平均直径9.6 cm,均有包膜。组织学检查显示所有病例均存在实性片块、假乳头结构。常可见出血、泡沫细胞及胆固醇结晶。免疫组织化学检查显示,8例α1-抗胰蛋白酶(alpha(1)-AT)和溶菌酶阳性;6例波形蛋白阳性,2例肌动蛋白阳性,1例肿瘤细胞巢中发现嗜铬粒蛋白A(CgA)阳性细胞。所有病例孕激素受体(PR)均阳性,4例大部分肿瘤细胞雌激素受体(ER)免疫反应阳性,但所有病例细胞角蛋白AE1(CK AE1)、细胞角蛋白AE3(CK AE3)、上皮膜抗原(EMA)、突触素、促肾上腺皮质激素(ACTH)、胃泌素、生长抑素、胰岛素及胰高血糖素均阴性。3例电子显微镜检查显示肿瘤细胞分化具有多态性,包括向导管、腺泡及内分泌细胞的过渡形态。8例中有1例肿瘤细胞中发现Weibel-Palade小体。
(1)CSTP是年轻女性患者中一种独特的临床病理实体,临床过程良性。(2)CSTP起源于原始胰腺细胞,具有向导管、腺泡及内分泌细胞分化的潜能。