Ishii Shotaro, Kobayashi Go, Fujita Naotaka, Noda Yutaka, Ito Kei, Horaguchi Jun, Koshita Shinsuke, Kanno Yoshihide, Ogawa Takahisa, Masu Kaori, Hashimoto Shinichi, Sawai Takashi, Uzuki Miwa
Departemetnt of Gastroenterology, Sendai City Medical Center, Japan.
Intern Med. 2012;51(24):3373-7. doi: 10.2169/internalmedicine.51.8779. Epub 2012 Dec 15.
We herein report a case of pancreatic undifferentiated carcinoma involving intraductal pedunculated polypoid growth. Duodenoscopy disclosed a congested polypoid mass protruding from the orifice of the papilla of Vater. Endoscopic retrograde pancreatography (ERP) showed a polypoid lesion in Wirsung's duct and Santorini's duct. Pancreatic juice cytology using the cell block method revealed the presence of undifferentiated carcinoma. No extraductal invasion was detected on endoscopic ultrasonography and or intraductal ultrasonography. The patient therefore underwent pancreaticoduodenectomy. A histological examination revealed an intraductal polypoid tumor with a thin stalk without extraductal invasion. The tumor was composed of an abundant mixture of pleomorphic cells, spindle cells, giant cells, and a small amount of adenocarcinoma.
我们在此报告一例胰腺未分化癌,伴有导管内带蒂息肉样生长。十二指肠镜检查发现一个充血的息肉样肿物从 Vater 乳头开口处突出。内镜逆行胰胆管造影(ERP)显示在主胰管和副胰管中有一个息肉样病变。采用细胞块法进行的胰液细胞学检查发现存在未分化癌。内镜超声检查和导管内超声检查均未检测到导管外侵犯。因此,该患者接受了胰十二指肠切除术。组织学检查显示为一个带细蒂的导管内息肉样肿瘤,无导管外侵犯。肿瘤由多形性细胞、梭形细胞、巨细胞以及少量腺癌大量混合组成。