Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Pancreas. 2010 Jan;39(1):88-91. doi: 10.1097/mpa.0b013e3181bba268.
Anaplastic carcinoma of the pancreas (ACP) is an aggressive variant of ductal adenocarcinoma. The aim of this study was to describe a single-center experience with the use of endoscopic ultrasound (EUS) with or without fine-needle aspiration (FNA) for the diagnosis of ACP.
The cytology and surgical pathology databases were searched for a diagnosis of ACP between 1992 and 2008. Demographic, clinical,surgical, radiographic, pathological, and EUS data were abstracted.
Thirteen patients with ACP were identified, which represented 0.8% of all pancreatic cancers diagnosed during the study period. Six of 13 patients had EUS. Features of these 6 tumors: median diameter of 42 mm (range, 20-100 mm), hypoechoic (n = 6), solid (n = 3) or mixed solid and cystic (n = 3), heterogeneous (n = 5) or homogeneous (n = 1),and well defined (n = 2) or poorly defined (n = 4) borders. Five underwent EUS-FNA of a pancreatic mass, and cytology demonstrated ACP in 4 and ductal adenocarcinoma in 1. The diagnosis of ACP was confirmed after surgical resection in 2 of these 5, including one in whom cytology demonstrated only adenocarcinoma. The sixth patient had EUS without FNA, and surgical pathology after distal pancreatectomy found ACP.
Anaplastic carcinoma of the pancreas has variable endosonographic features. Endoscopic ultrasound-FNA may assist in the cytological diagnosis of these tumors.
胰腺间变大细胞癌（ACP）是一种具有侵袭性的导管腺癌变体。本研究旨在描述使用内镜超声（EUS）联合或不联合细针抽吸（FNA）进行诊断的单中心经验。
在 1992 年至 2008 年期间，通过细胞学和手术病理数据库搜索诊断为 ACP 的病例。提取人口统计学、临床、手术、影像学、病理和 EUS 数据。
共发现 13 例 ACP 患者，占同期诊断的所有胰腺癌的 0.8%。13 例患者中有 6 例行 EUS。这 6 例肿瘤的特征为：中位直径 42mm（范围 20-100mm），低回声（n=6），实性（n=3）或实性和囊性混合（n=3），不均匀（n=5）或均匀（n=1），边界清晰（n=2）或不清晰（n=4）。5 例行 EUS-FNA 检查胰腺肿块，细胞学检查显示 4 例为 ACP，1 例为导管腺癌。其中 5 例中的 2 例在手术切除后确诊为 ACP，包括 1 例在细胞学检查中仅显示腺癌。第六例患者行 EUS 检查但未行 FNA，远端胰腺切除术后的手术病理发现 ACP。
胰腺间变大细胞癌的超声内镜表现具有多样性。EUS-FNA 可能有助于这些肿瘤的细胞学诊断。
