Benning T L, Silverman J F, Berns L A, Geisinger K R
Department of Pathology, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354.
Acta Cytol. 1992 Jul-Aug;36(4):471-6.
The fine needle aspiration (FNA) cytology findings in 19 cases of hematopoietic and metastatic neoplasms that radiographically mimicked primary pancreatic carcinoma are reported. These cases represented 11% of 176 malignant diagnoses in a series of 304 pancreatic FNAs. The cytologic diagnoses included 7 non-Hodgkin's lymphomas, 2 Hodgkin's lymphomas, 6 small cell carcinomas (4 lung, 1 gallbladder, 1 skin), 3 squamous cell carcinomas (2 cervix, 1 esophagus) and 1 hepatocellular carcinoma. In six cases the pancreatic lesion was the initial presentation of malignant disease. These included five lymphomas, which probably involved peripancreatic lymph nodes, and a metastatic small cell carcinoma of pulmonary origin. Recognition of unusual morphologic features of pancreatic carcinoma raised the possibility of extrapancreatic malignancies. Electron microscopy and immunocytochemistry performed on FNA specimens were helpful in selected cases. The FNA diagnosis of hematopoietic and metastatic neoplasms that clinically mimic pancreatic carcinoma prompts appropriate clinical studies and treatment and eliminates the need for open pancreatic biopsy and/or resection.
报告了19例影像学表现类似原发性胰腺癌的造血系统和转移性肿瘤的细针穿刺（FNA）细胞学检查结果。在304例胰腺FNA的一系列病例中，这些病例占176例恶性诊断的11%。细胞学诊断包括7例非霍奇金淋巴瘤、2例霍奇金淋巴瘤、6例小细胞癌（4例来自肺、1例来自胆囊、1例来自皮肤）、3例鳞状细胞癌（2例来自宫颈、1例来自食管）和1例肝细胞癌。在6例中，胰腺病变是恶性疾病的首发表现。其中包括5例淋巴瘤，可能累及胰腺周围淋巴结，以及1例肺源性转移性小细胞癌。对胰腺癌不寻常形态特征的认识增加了胰腺外恶性肿瘤的可能性。对FNA标本进行的电子显微镜检查和免疫细胞化学检查在某些病例中很有帮助。对临床上类似胰腺癌的造血系统和转移性肿瘤进行FNA诊断可促使进行适当的临床研究和治疗，并消除了进行开放性胰腺活检和/或切除的必要性。
