Rao Ram Nawal, Vij Mukul, Singla Nidhi, Kumar Ashok
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India.
JOP. 2011 May 6;12(3):283-6.
Pancreatic extra-gastrointestinal stromal tumors are extremely uncommon neoplasm. To the best of our knowledge, only eleven cases have been reported in the literature. All the case reports published mostly involve diagnoses made on surgical pathology.
A 40-year-old male patient presented with asthenia, mild abdominal pain, severe anemia and weight loss. Contrast-enhanced computed tomography of the abdomen revealed a heterogeneously enhancing mass (6.5x6.0 cm) in the body and head of the pancreas. Ultrasound-guided fine needle aspiration (US-FNA) was performed on the mass of the pancreas before a pancreaticoduodenectomy. A cytological diagnosis of pancreatic malignant mesenchymal neoplasm was made. The final diagnosis of primary pancreatic extra-gastrointestinal stromal tumor was confirmed by histopathological examination and immunohistochemical findings (CD117 positivity). This case was diagnosed by percutaneous transabdominal ultrasound, rather than endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) which had been used in three previous cases.
We report a very unusual case of pancreatic extra-gastrointestinal stromal tumor which was diagnosed by US-FNA cytology. Although this is uncommon in the pancreas, extra-gastrointestinal stromal tumors should be considered in the differential diagnosis of solid and cystic pancreatic masses on cytology.
胰腺外胃肠道间质瘤是极为罕见的肿瘤。据我们所知，文献中仅报道了11例。已发表的所有病例报告大多涉及手术病理诊断。
一名40岁男性患者出现乏力、轻度腹痛、严重贫血和体重减轻。腹部增强计算机断层扫描显示胰腺体部和头部有一个不均匀强化的肿块（6.5×6.0厘米）。在胰十二指肠切除术之前，对胰腺肿块进行了超声引导下细针穿刺活检（US-FNA）。做出了胰腺恶性间叶性肿瘤的细胞学诊断。通过组织病理学检查和免疫组化结果（CD117阳性）确诊为原发性胰腺外胃肠道间质瘤。该病例通过经皮腹部超声诊断，而非之前三例中使用的内镜超声引导下细针穿刺活检（EUS-FNA）。
我们报告了一例通过US-FNA细胞学诊断的非常罕见的胰腺外胃肠道间质瘤病例。尽管这种情况在胰腺中不常见，但在胰腺实性和囊性肿块的细胞学鉴别诊断中应考虑到胃肠道间质瘤。
