[经胶囊内镜诊断为无功能胰腺神经内分泌肿瘤十二指肠浸润所致隐匿性胃肠道出血：病例报告]

[Obscure gastrointestinal bleeding due to duodenal infiltration of a non-functioning pancreatic neuroendocrine tumor diagnosed by capsule endoscopy: a case report].

作者信息

García-Compeán D, Jáquez-Quintana J O, González-González J A, Hernández-Martínez S, Reyes-Cabello E A, Ramírez-Monterrubio L, Garza-Galindo A A, Maldonado-Garza H J

机构信息

Servicio de Gastroenterología del Departamento de Medicina Interna, Hospital Universitario Dr. José E. González y Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, N. L., México.

出版信息

Rev Gastroenterol Mex. 2011 Oct-Dec;76(4):370-4.

PMID:22188965

Abstract

Non-functioning pancreatic neuroendocrine tumors (PNETs) are infrequent slow-growing, clinically-silent tumors. They are incidentally detected and some of them may present in advanced stages with local involvement of surrounding structures. The diagnostic accuracy of endoscopio ultrasound (EUS) and fine needle aspiration (FNA) biopsy is significantly lower in neuroendocrine tumors (46.7%) compared with adenocarcinoma (81.4%) and other histologies (75%). Therefore, preoperative diagnosis is very difficult. Exceptionally, hey present with gastrointestinal bleeding. We present a case of a non-functioning PNET initially diagnosed as cystic serous tumor of pancreas with EUS and FNA biopsy. Two years later patient presented obscure gastrointestinal bleeding due to duodenal infiltration. Diagnosis was made by capsule endoscopy.

摘要

无功能性胰腺神经内分泌肿瘤（PNETs）是罕见的、生长缓慢、临床上无症状的肿瘤。它们多为偶然发现，其中一些可能在晚期出现，伴有周围结构的局部受累。与腺癌（81.4%）和其他组织学类型（75%）相比，内镜超声（EUS）和细针穿刺（FNA）活检对神经内分泌肿瘤的诊断准确性显著较低（46.7%）。因此，术前诊断非常困难。极个别情况下，它们会表现为胃肠道出血。我们报告一例无功能性PNET病例，最初经EUS和FNA活检诊断为胰腺囊性浆液性肿瘤。两年后，患者因十二指肠浸润出现不明原因的胃肠道出血。通过胶囊内镜检查做出了诊断。