Kamei K, Funabiki T, Ochiai M, Amano H, Kasahara M, Sakamoto T
Department of Surgery, Fujita-Gakuen Health University School of Medicine, Aichi, Japan.
Int J Pancreatol. 1991 Oct;10(2):161-72. doi: 10.1007/BF02924154.
A case of multifocal pancreatic serous cystadenoma with atypical cells is reported. The patient was a 72-yr-old female who complained of jaundice. The distal common bile duct was obstructed, and the proximal bile duct was remarkably dilated on cholangiography. The main portal vein was obstructed and collateral vessels had developed on portal angiography. Total pancreatectomy was performed. The resected specimen contained one tumor in the head of the pancreas, five in the body, and one in the tail. The tumors of the head and body were morphologically the same. Microscopically, both contained spongelike multilocular cysts on their cut surfaces. These cysts were covered with low cuboid epithelium containing clear cytoplasm and abundant glycogen. Neural invasion was also found. The tumor cells exhibited an increased N/C ratio, variable nuclear size, irregular nuclear margins, and coarse nuclear chromatin. These tumors had aneuploid nuclear DNA with a DNA index of 1.9 and a proliferation index of 0.28. We feel that it is necessary to reconsider the biological concept of serous cystadenoma.
报告了一例伴有非典型细胞的多灶性胰腺浆液性囊腺瘤病例。患者为一名72岁女性，主诉黄疸。胆管造影显示胆总管远端梗阻，近端胆管明显扩张。门静脉造影显示门静脉主干梗阻并出现侧支血管。行全胰切除术。切除标本中，胰头有1个肿瘤，胰体有5个，胰尾有1个。胰头和胰体的肿瘤形态相同。显微镜下，两者切面均可见海绵状多房囊肿。这些囊肿被覆低立方上皮，细胞质清亮，糖原丰富。还发现有神经侵犯。肿瘤细胞显示核质比增加、核大小不一、核边缘不规则及核染色质粗糙。这些肿瘤核DNA为非整倍体，DNA指数为1.9，增殖指数为0.28。我们认为有必要重新审视浆液性囊腺瘤的生物学概念。
