Reese Stephen A, Traverso L William, Jacobs Timothy W, Longnecker Daniel S
Department of General Surgery, Virginia Mason Medical Center, Seattle, WA 98111, USA.
Pancreas. 2006 Jul;33(1):96-9. doi: 10.1097/01.mpa.0000226890.63451.c4.
We report the third case of a solid serous adenoma of the pancreas, a rare variant of tumor within the family of pancreatic serous cystic neoplasms. This asymptomatic tumor presented in a 66-year-old man during imaging for another problem. Computed tomography of the abdomen demonstrated a 3.5-cm hypervascular mass in the head of the pancreas. A pylorus preserving pancreaticoduodenectomy was performed. Histological examination demonstrated a neoplasm identical to a serous cystadenoma-glycogen-rich cuboidal or polygonal cells with finely granulated eosinophilic or clear cytoplasm. More often, the neoplasm contained solid areas and tubules but no microcysts. Periodic acid Schiff's-glycogen staining was positive in some cells, turning negative after diastase was applied. Immunostaining was positive for CK7, CK8, neuron specific enolase, and MUC6. The microscopic findings of a solid neoplasm of cuboidal cells rich in glycogen and the immunostaining listed associate this tumor with the previously 2 reported cases of solid serous adenoma. All 3 reported cases thus far have proven to be benign lesions by pathological examination. Because clinical follow-up is reported only in the present case, caution should be exercised in declaring the solid serous adenoma of the pancreas as a benign lesion.
我们报告了胰腺实性浆液性腺瘤的第三例病例,这是胰腺浆液性囊性肿瘤家族中的一种罕见肿瘤变体。该无症状肿瘤在一名66岁男性因其他问题进行影像学检查时被发现。腹部计算机断层扫描显示胰腺头部有一个3.5厘米的高血管性肿块。实施了保留幽门的胰十二指肠切除术。组织学检查显示肿瘤与浆液性囊腺瘤相同,由富含糖原的立方形或多边形细胞组成,细胞质呈细颗粒状嗜酸性或透明状。更常见的是,肿瘤包含实性区域和小管,但没有微囊肿。高碘酸希夫糖原染色在一些细胞中呈阳性,应用淀粉酶后变为阴性。免疫染色对CK7、CK8、神经元特异性烯醇化酶和MUC6呈阳性。富含糖原的立方形细胞实性肿瘤的微观发现以及列出的免疫染色结果将该肿瘤与之前报道的2例实性浆液性腺瘤病例相关联。迄今为止报告的所有3例病例经病理检查均被证明为良性病变。由于仅在本病例中有临床随访报告,因此在将胰腺实性浆液性腺瘤宣布为良性病变时应谨慎。