Kimura W, Shimada H, Akabane H
Department of Clinical Pathology, Tokyo Metropolitan Institute of Gerontology, Japan.
Hepatogastroenterology. 1991 Oct;38(5):396-9.
A case of pancreatic duct cell carcinoma with ossification was reported. A 71-year-old female died of pancreas carcinoma with liver and diffuse lymph node metastasis. Computed tomography (CT) revealed a punctate calcification of the body of the pancreas. At autopsy, the carcinoma occupied almost all of the pancreas, and histological examination revealed a moderately to well-differentiated adenocarcinoma with mucin production in the glands. The whole of the pancreas was examined microscopically by multiple-step sections, and mature ossification was found in the body, corresponding to its CT localization. Around the ossification were found cancer cells with massive mucin in the cytoplasm, capillary proliferation, scattered necrosis and mesenchymal cells, which were thought to be fibroblasts. But neither cartilage nor calcification was found. The pathogenesis of ossification was believed to be associated with metaplastic changes of mesenchymal cells. This is the fourth case of pancreatic carcinoma with ossification, and the second case of pancreatic duct cell carcinoma with mature bone formation to have been reported.
报告了一例伴有骨化的胰腺导管细胞癌病例。一名71岁女性死于伴有肝和弥漫性淋巴结转移的胰腺癌。计算机断层扫描(CT)显示胰腺体部有斑点状钙化。尸检时,癌几乎占据整个胰腺,组织学检查显示为中度至高分化腺癌,腺体内有黏液分泌。通过多步切片对整个胰腺进行显微镜检查,在胰腺体部发现了成熟骨化,与CT定位相符。在骨化周围发现了癌细胞,其细胞质内有大量黏液、毛细血管增生、散在坏死以及间充质细胞,这些间充质细胞被认为是成纤维细胞。但未发现软骨或钙化。骨化的发病机制被认为与间充质细胞的化生改变有关。这是第四例伴有骨化的胰腺癌病例,也是第二例报告的伴有成熟骨形成的胰腺导管细胞癌病例。