Ogawa Masami, Kawaguchi Yoshiaki, Uchida Tetsufumi, Ito Hiroyuki, Mine Tetsuya
Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2011 Sep 20;36(3):75-8.
The usefulness of endoscopic ultrasound (EUS) in the diagnosis of small pancreatic cancer is widely accepted. We experienced a small, 8 mm, pancreatic cancer with intra-pancreatic metastasis of 2 mm revealed by EUS. The patient was a 71-year-old female with a small low echoic tumor observed by abdominal ultrasonography. She was referred to our hospital for further investigation. She complained of mild abdominal pain. She had a past history of myoma uteri. Ultrasonography showed a 10 mm low echoic mass in the body of the pancreas, but it was difficult to make a distinction between a solid mass and a cystic lesion. No tumor was shown by CT or MRI. EUS was performed, and showed a solid low echoic tumor of 8 mm and a low echoic mass of 2 mm in a diameter near the tumor. An ERCP study was performed, but the cytology of the normal main pancreatic duct was shown to be benign. We diagnosed the patient with pancreatic cancer, and surgery was performed. A pathological examination revealed a 10 mm invasive ductal carcinoma and intra-pancreatic metastasis.
内镜超声（EUS）在诊断小胰腺癌方面的实用性已被广泛认可。我们遇到了一例通过EUS发现的小胰腺癌，肿瘤大小为8mm，伴有2mm的胰腺内转移。患者为一名71岁女性，腹部超声检查发现一个小的低回声肿瘤。她因进一步检查被转诊至我院。她主诉轻度腹痛。她有子宫肌瘤病史。超声显示胰腺体部有一个10mm的低回声肿块，但很难区分实性肿块和囊性病变。CT或MRI未显示肿瘤。进行了EUS检查，显示一个8mm的实性低回声肿瘤，以及在肿瘤附近有一个直径2mm的低回声肿块。进行了ERCP检查，但主胰管的细胞学检查显示为良性。我们诊断该患者为胰腺癌，并进行了手术。病理检查显示为一个10mm的浸润性导管癌及胰腺内转移。
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