Beltrán Marcelo A, Barría Carlos, Naquira Cecilia, Almonacid Jorge, Cruces Karina S
Unidad de Emergencia, Hospital de La Serena, Chile.
Rev Med Chil. 2007 Oct;135(10):1318-22. Epub 2007 Dec 20.
Pancreatic choristoma is the occurrence of normal pancreatic tissue in an abnormal location without any anatomic continuity with the main body of the gland. Although heterotopia is uncommon in the gallbladder and biliary tract, anecdotic cases of gastric mucosa, liver, adrenal gland and pancreas among other tissues have been described. We report an eight year-old male and a 22 year-old female, electively operated for symptomatic cholelithiasis. On pathology, a nodule identified as a pancreatic endocrine and exocrine choristoma, was found in the gallbladder wall of both patients. We employed immunohistochemistry to characterize this choristoma. Tubular and epithelial structures were immunoreactive to cytokeratins 7, 8, 18, 19 and 20 and to CA19-9. Exocrine activity was documented by immunoreactivity to al-antitrypsin and al-chemotrypsin. Other immunohistochemical markers such as insulin and somatostatin were positive identifying endocrine activity.
胰腺迷离瘤是指正常胰腺组织出现在异常部位，且与胰腺主体无任何解剖学上的连续性。尽管胆囊和胆道的异位情况并不常见，但已有文献报道过胃黏膜、肝脏、肾上腺及胰腺等组织的个别病例。我们报告了一名8岁男性和一名22岁女性，因有症状的胆结石而接受择期手术。病理检查发现，两名患者的胆囊壁上均有一个被鉴定为胰腺内分泌和外分泌迷离瘤的结节。我们采用免疫组织化学方法对该迷离瘤进行特征描述。管状和上皮结构对细胞角蛋白7、8、18、19和20以及CA19-9呈免疫反应性。对α1-抗胰蛋白酶和α1-糜蛋白酶的免疫反应性证明了外分泌活性。其他免疫组织化学标志物如胰岛素和生长抑素呈阳性，证实了内分泌活性。
