Cappellari J O, Geisinger K R, Albertson D A, Wolfman N T, Kute T E
Department of Pathology, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Cancer. 1990 Jul 1;66(1):193-8. doi: 10.1002/1097-0142(19900701)66:1<193::aid-cncr2820660134>3.0.co;2-6.
An example of the rare papillary cystic tumor of the pancreas was diagnosed cytologically by aspiration of the primary neoplasm. Subsequently, it metastasized, proving its low-grade malignant behavior. Diagnostic cytomorphologic features included abundant straight and branched papillary tissue fragments, and uniform, pale nuclei with folds or grooves. Although the primary tumor had a typical histologic appearance, metastases demonstrated increased nuclear pleomorphism and hyperchromasia, bizarre tumor giant cells, and an increased mitotic rate. Vimentin was diffusely positive, whereas neuron-specific enolase and somatostatin were focally and weakly reactive. Neurosecretory and zymogen granules were absent ultrastructurally. By flow cytometric study, the tumor was aneuploid (DNA Index = 1.3).
通过对原发性肿瘤进行穿刺抽吸，从细胞学上诊断出一例罕见的胰腺乳头状囊性肿瘤。随后，该肿瘤发生转移，证实其具有低级别恶性行为。诊断性细胞形态学特征包括大量直的和分支状的乳头状组织碎片，以及均匀、淡染的细胞核，细胞核有褶皱或沟纹。尽管原发性肿瘤具有典型的组织学表现，但转移灶显示核多形性增加、核深染、出现奇异的肿瘤巨细胞以及有丝分裂率增加。波形蛋白弥漫性阳性，而神经元特异性烯醇化酶和生长抑素呈局灶性弱阳性反应。超微结构下未见神经分泌颗粒和酶原颗粒。通过流式细胞术研究，该肿瘤为非整倍体（DNA指数 = 1.3）。
