Chu H W, Ho W L, Chang S M
Department of Pathology, Veterans General Hospital-Taichung, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Feb;47(2):139-44.
Papillary cystic tumor of the pancreas almost always occurs in young female patient and metastasis is extremely rare although local recurrence may occur. Prognosis is excellent and the tumor can be considered to be curable by surgery. Reported here is an unusual case of malignant papillary cystic tumor of the pancreas that occurred in a 51 Y/O man with metastasis to bilateral inguinal soft tissue at the time of diagnosis. Beside distal pancreatectomy, subtotal gastrectomy and excision of the inguinal masses were also performed because of the presence of a separate tumor in the lesser sac, which was unrelated to the pancreas. Immunohistochemical staining for NSE was positive in tumor cells. However, electron microscopy failed to reveal neurosecretory or zymogen granules but there were abundant mitochondria, rough endoplasmic reticulum and annulate lamellae. These findings show that a ductal origin is more likely in our case but the hypothesis of an origin from a primitive cell capable of acinar, ductal or endocrine differentiation should also be considered.
胰腺乳头状囊性肿瘤几乎总是发生在年轻女性患者中，转移极为罕见，尽管可能会出现局部复发。预后良好，该肿瘤可被认为通过手术可治愈。本文报道了一例不寻常的胰腺恶性乳头状囊性肿瘤，发生在一名51岁男性，诊断时已转移至双侧腹股沟软组织。除了远端胰腺切除术外，由于小网膜囊内存在一个与胰腺无关的独立肿瘤，还进行了胃次全切除术和腹股沟肿块切除术。肿瘤细胞中NSE免疫组化染色呈阳性。然而，电子显微镜检查未发现神经分泌颗粒或酶原颗粒，但有丰富的线粒体、粗面内质网和环状片层。这些发现表明，在我们的病例中肿瘤更可能起源于导管，但也应考虑起源于能够进行腺泡、导管或内分泌分化的原始细胞这一假说。
