Kongkam P, Al-Haddad M, Attasaranya S, O'Neil J, Pais S, Sherman S, DeWitt J
Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana 46202-5121, USA.
Endoscopy. 2008 Jul;40(7):602-5. doi: 10.1055/s-2007-995740.
Pancreatic neuroendocrine tumors (PNETs) may rarely appear as cystic or mixed solid-cystic masses. The endoscopic ultrasound (EUS) morphology and cyst fluid characteristics of these tumors are not well clarified. We retrospectively identified nine adult patients with nine single cystic pancreatic neuroendocrine tumors (CNETs). These nine included 0.67 % of the 1344 patients with pancreatic cystic lesions and 9.5 % of the 95 confirmed PNETs evaluated over the 12-year study period. At presentation, four patients were asymptomatic and five had known acute pancreatitis (n = 2), MEN-1 syndrome with hypoglycemia (n = 1), and abdominal pain (n = 2). Median maximal tumor diameter was 26 mm (range 20 - 64 mm). EUS morphology was mixed solid and cystic (n = 4) or cystic alone (n = 5). Cytology from EUS-fine-needle aspiration (FNA) (median 2 passes; range 1 - 6) demonstrated a PNET, and immunocytochemistry was confirmatory in all patients. Cyst fluid carcinoembryonic antigen (CEA) (n = 4) and amylase (n = 5) ranged from 0.1 to 1.8 ng/ml (normal 0 - 2.5 ng/ml) and 72 to 1838 U/L (normal 25 - 161 U/L), respectively. Six patients underwent surgery, and the preoperative diagnosis was confirmed in all.
胰腺神经内分泌肿瘤（PNETs）很少表现为囊性或实性-囊性混合肿块。这些肿瘤的内镜超声（EUS）形态及囊液特征尚未完全明确。我们回顾性纳入了9例成年患者，均为单发囊性胰腺神经内分泌肿瘤（CNETs）。这9例患者占12年研究期间1344例胰腺囊性病变患者的0.67%，以及95例确诊PNETs患者的9.5%。就诊时，4例患者无症状，5例患者有已知的急性胰腺炎（2例）、伴有低血糖的多发性内分泌腺瘤1型（MEN-1综合征，1例）及腹痛（2例）。肿瘤最大直径中位数为26 mm（范围20 - 64 mm）。EUS形态为实性和囊性混合（4例）或单纯囊性（5例）。EUS细针穿刺活检（FNA）（穿刺次数中位数为2次；范围1 - 6次）的细胞学检查确诊为PNETs，所有患者免疫细胞化学检查均为阳性。囊液癌胚抗原（CEA）（4例）和淀粉酶（5例）分别为0.1至1.8 ng/ml（正常范围0 - 2.5 ng/ml）和72至1838 U/L（正常范围25 - 161 U/L）。6例患者接受了手术，所有患者术前诊断均得到证实。
