Yamaguchi Rin, Okabe Yoshinobu, Jimi Atsuo, Shiota Koji, Kodama Takahito, Naito Yoshiki, Yasunaga Masafumi, Kinoshita Hisafumi, Kojiro Masamichi
Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.
Pathol Int. 2006 Oct;56(10):633-7. doi: 10.1111/j.1440-1827.2006.02020.x.
Acinar cell carcinoma (ACC) of the pancreas is relatively rare, accounting for only approximately 1% of all exocrine pancreatic tumors. A 69-year-old man was found to have a mass lesion measuring approximately 4 cm in diameter in the pancreatic head on ultrasound, abdominal dynamic CT, and percutaneous transhepatic cholangiography. Magnetic resonance cholangiopancreatography showed defect of the lower common bile duct (CBD) due to obstruction by the tumor cast. Histopathologically, the pancreatic head tumor invaded the main pancreatic duct (MPD) and CBD with extension into the CBD in a form of tumor cast. The tumor cells consisted of a solid proliferation with abundant eosinophilic cytoplasm and round nuclei in an acinar and trabecular fashion. A 55-year-old man with upper abdominal pain and nausea, had a cystic lesion approximately 3 cm in size in the pancreatic tail on CT. Histopathologically, the tumor was encapsulated by fibrous capsule and had extensive central necrosis with solid areas in the tumor periphery, and invaded with extension into the MPD in a form of tumor cast. The tumor cells resembled acinar cells in solid growths. Two resected cases of ACC with unusual tumor extension into the CBD and the MPD, respectively, are reported.
胰腺腺泡细胞癌（ACC）相对罕见，仅占所有胰腺外分泌肿瘤的约1%。一名69岁男性在超声、腹部动态CT和经皮经肝胆管造影检查中发现胰头部有一个直径约4 cm的肿块病变。磁共振胰胆管造影显示，由于肿瘤栓子阻塞，胆总管下段（CBD）出现缺损。组织病理学检查显示，胰头部肿瘤侵犯主胰管（MPD）和CBD，并以肿瘤栓子的形式延伸至CBD。肿瘤细胞呈实性增殖，具有丰富的嗜酸性细胞质和圆形细胞核，呈腺泡状和小梁状排列。一名55岁男性，有上腹部疼痛和恶心症状，CT检查发现胰尾部有一个大小约3 cm的囊性病变。组织病理学检查显示，肿瘤被纤维包膜包裹，有广泛的中央坏死，肿瘤周边为实性区域，并以肿瘤栓子的形式侵犯并延伸至MPD。肿瘤细胞在实性生长中类似于腺泡细胞。本文报告了两例ACC切除病例，分别出现了肿瘤向CBD和MPD的异常延伸。
