Sylla Abdoullaye, Hervieu Valérie, Lombard-Bohas Catherine, Tanière Philippe, Elbaz Nadine, Scoazec Jean-Yves
Service Central d'Anatomie et Cytologie Pathologiques, Hôpital Edouard Herriot, Lyon.
Ann Pathol. 2003 Oct;23(5):424-9.
Amphicrine carcinomas are rare tumors defined by the presence of tumor cells showing evidence of both exocrine and endocrine differentiation. We here report two cases of amphicrine carcinomas of the pancreas, an exceedingly rare localization for this type of tumors. Diagnosis was made in respectively, a 32-year-old woman and a 66-year-old man; tumors measured 7 and 3 cm in diameter; metastatic dissemination was present in both cases. The first patient, treated by surgery and chemotherapy, is alive, without disease progression, after 26 months; the second patient deceased early after the diagnosis. In both cases, the first diagnosis considered at cytological and histological examination was endocrine carcinoma. The amphicrine nature of the lesion was ascertained by the combined demonstration of mucus staining and chromogranin A expression in the same cells. In one case, the amphicrine nature of tumor cells was confirmed by the ultrastructural examination. The identification of the amphicrine nature of an apparently endocrine tumor is of relevance, because of the poor prognosis of amphicrine carcinomas as compared to endocrine carcinomas and the requirement for aggressive therapy.
两性癌是一种罕见的肿瘤，其定义为肿瘤细胞同时显示出外分泌和内分泌分化的证据。我们在此报告两例胰腺两性癌，这种肿瘤在此部位极为罕见。诊断分别在一名32岁女性和一名66岁男性中做出；肿瘤直径分别为7厘米和3厘米；两例均有转移扩散。首例患者接受手术和化疗，26个月后仍存活，无疾病进展；第二例患者在诊断后不久死亡。在这两例中，细胞学和组织学检查最初考虑的诊断均为内分泌癌。通过在同一细胞中同时显示黏液染色和嗜铬粒蛋白A表达，确定了病变的两性本质。在其中一例中，肿瘤细胞的两性本质通过超微结构检查得以证实。识别明显的内分泌肿瘤的两性本质具有重要意义，因为与内分泌癌相比，两性癌预后较差，且需要积极治疗。
