Terada Tadashi
Department of Pathology, Shizuoka City Shimizu Hospital Shizuoka, Japan.
Int J Clin Exp Pathol. 2012;5(1):52-7. Epub 2012 Jan 1.
The author investigated histopathology of 615 consecutive duodenal specimens in our pathology laboratory in Japan. A computer review of the duodenal specimens was done. In cases of malignancy, histological slides were reviewed. The duodenal specimens were composed of 567 benign lesions (92%) and 48 malignant lesions (8%). The 48 malignant lesions were composed of 20 cases (42%) of primary adenocarcinoma, 10 cases (21%) of primary adenocarcinoma of ampulla Vater, 4 cases (8%) of primary squamous cell carcinoma, 1 (2%) cases of primary spindle cell carcinoma, 4 (8%) cases of carcinoid tumors, 1 (2%) case of malignant lymphoma, and 8 cases (17%) of secondary carcinoma from the pancreatic carcinoma or bile duct carcinoma. The primary adenocarcinoma (n=20) was composed of well differentiated adenocarcinoma (n=9), papillary adenocarcinoma (n=1), moderately differentiated adenocarcinoma (n=6), and poorly differentiated adenocarcinoma (n=4). The primary adenocarcinoma of the ampulla of Vater (n=10) was composed of well differentiated adenocarcinoma (n=7) and moderately differentiated adenocarcinoma (n=3). The primary squamous cell carcinoma (n=4) showed proliferation of malignant squamous cells with keratinization and intercellular bridges. The spindle cell carcinoma (n=1) consisted of only malignant spindle cells immunohistochemistry positive for various cytokeratins and vimentin. The carcinoid tumor (n=4) was typical carcinoid and showed organoid, trabecular, and ribbon-like arrangements. The carcinoid tumor was immunohistochemically positive for neuroendocrine markers such as CD56, neuron-specific enolase and synaptophysin. The malignant lymphoma (n=1) was diffuse large B-cell lymphoma immunohistochemically positive for CD10, CD20, and CD79α. The secondary carcinoma (n=8) was adenocarcinoma invaded from the pancreatic adenocarcinoma (n=6) and extrahepatic bile duct adenocarcinoma (n=2).
作者对日本我们病理实验室连续的615份十二指肠标本进行了组织病理学研究。对十二指肠标本进行了计算机回顾。对于恶性肿瘤病例，对组织学切片进行了复查。十二指肠标本包括567例良性病变（92%）和48例恶性病变（8%）。48例恶性病变包括20例（42%）原发性腺癌、10例（21%）壶腹 Vater 原发性腺癌、4例（8%）原发性鳞状细胞癌、1例（2%）原发性梭形细胞癌、4例（8%）类癌肿瘤、1例（2%）恶性淋巴瘤以及8例（17%）来自胰腺癌或胆管癌的继发性癌。原发性腺癌（n = 20）包括高分化腺癌（n = 9）、乳头状腺癌（n = 1）、中分化腺癌（n = 6）和低分化腺癌（n = 4）。壶腹 Vater 原发性腺癌（n = 10）包括高分化腺癌（n = 7）和中分化腺癌（n = 3）。原发性鳞状细胞癌（n = 4）表现为恶性鳞状细胞增殖并伴有角化和细胞间桥。梭形细胞癌（n = 1）仅由对各种细胞角蛋白和波形蛋白免疫组化呈阳性的恶性梭形细胞组成。类癌肿瘤（n = 4）为典型类癌，呈器官样、小梁状和带状排列。类癌肿瘤对神经内分泌标志物如CD56、神经元特异性烯醇化酶和突触素免疫组化呈阳性。恶性淋巴瘤（n = 1）为弥漫性大B细胞淋巴瘤，对CD10、CD20和CD79α免疫组化呈阳性。继发性癌（n = 8）为来自胰腺腺癌（n = 6）和肝外胆管腺癌（n = 2）的浸润性腺癌。
