Lee Kwang Hyuck, Lee Jae Seung, Kim Bum Jin, Lee Jong Kyun, Kim Seong Hyun, Kim Seung Hoon, Lee Kyu Taek
Department of Internal Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Gangnam-gu, Seoul, Korea.
J Gastroenterol. 2009;44(5):447-52. doi: 10.1007/s00535-009-0021-2. Epub 2009 Mar 31.
The aim of this study was to describe pancreatic involvement in von Hippel-Lindau (VHL) disease and to document the changes that occur in pancreatic lesions.
We retrospectively analyzed the medical records and CT scans of 18 VHL patients who were diagnosed between 1994 and 2007 at the Samsung Medical Center. The clinical history with a detailed family history, biochemical test results, and imaging studies of the pancreas, adrenal glands, and kidneys were reviewed. Genetic analysis was performed in 12 patients. The changes in pancreatic lesions, such as an increase in cystic lesions, calcifications, and dilatation of the pancreatic duct, were analyzed in patients who had CT scans at least 1 year apart.
Pancreatic lesions existed in 89% (16/18) of the patients. All 16 patients had multiple cystic lesions. Two patients had co-existing neuroendocrine tumors (NET), and two patients had co-existing serous cystadenomas (SCA). At least one of three features of pancreatic lesions (cystic lesions, calcifications, and dilatation of the pancreatic duct) progressed in all nine patients who had CT scans 1 year apart.
Pancreatic involvement in VHL disease was relatively common in Korean patients. The most common type of pancreatic involvement was a multiple cystic lesion. NET and SCA existed in approximately 10% of VHL patients with pancreatic involvement. Pancreatic lesions in VHL disease progressed, at least according to radiological images.
本研究旨在描述胰腺在冯·希佩尔-林道(VHL)病中的受累情况,并记录胰腺病变所发生的变化。
我们回顾性分析了1994年至2007年间在三星医疗中心确诊的18例VHL患者的病历和CT扫描结果。回顾了详细的家族病史、临床病史、生化检查结果以及胰腺、肾上腺和肾脏的影像学研究。对12例患者进行了基因分析。对间隔至少1年进行CT扫描的患者,分析胰腺病变的变化,如囊性病变增加、钙化以及胰管扩张。
89%(16/18)的患者存在胰腺病变。所有16例患者均有多发囊性病变。2例患者合并神经内分泌肿瘤(NET),2例患者合并浆液性囊腺瘤(SCA)。在间隔1年进行CT扫描的所有9例患者中,胰腺病变的三个特征(囊性病变、钙化、胰管扩张)中至少有一个出现进展。
在韩国患者中,胰腺受累于VHL病较为常见。胰腺受累最常见的类型是多发囊性病变。在约10%有胰腺受累的VHL患者中存在NET和SCA。至少从影像学图像来看,VHL病中的胰腺病变会进展。