Kim Y I, Seo J W, Suh J S, Lee K U, Choe K J
Department of Pathology, College of Medicine, Seoul National University, Korea.
Am J Clin Pathol. 1990 Aug;94(2):150-6. doi: 10.1093/ajcp/94.2.150.
Three cases of microcystic adenomas of the pancreas with special reference to multicentric origin are described. The gross features and light microscopic findings were consistent with those described as being microcystic adenomas, but in two cases the gross examination and gelatin-embedded giant slices revealed multiple, isolated development of tumors ranging from submacroscopic nodules to tumors 4.5 cm in diameter. The larger tumors often showed ragged margins with small satellite nodules around the masses. A central fibrolamellar stellate core with centrifugally radiating septation was found in most of the tumor masses, even in the smaller ones. Ultrastructural and immunohistochemical findings revealed a single row of glycogen-rich epithelial cells, but participation of myoepithelial cells was not confirmed. Instead, vimentin-positive cells (pericytes) within the interstitial space incorporated closely with the basal lamina of the cyst wall. This study suggests that a small percentage of microcystic adenomas of the pancreas develop in multiple tumors, and some appear as a single tumor by their confluence.
本文描述了3例胰腺微囊性腺瘤，特别提及多中心起源。大体特征和光镜检查结果与文献中描述的微囊性腺瘤一致，但在2例中，大体检查和明胶包埋的巨块切片显示肿瘤呈多个孤立性生长，大小从亚宏观结节至直径4.5 cm的肿瘤不等。较大的肿瘤边缘常参差不齐，周围有小卫星结节。在大多数肿瘤块中，即使是较小的肿瘤，也发现有中央纤维板层状星状核心并伴有离心性放射状分隔。超微结构和免疫组化结果显示为单行富含糖原的上皮细胞，但未证实有肌上皮细胞参与。相反，间质内波形蛋白阳性细胞（周细胞）与囊壁基底膜紧密结合。本研究提示，一小部分胰腺微囊性腺瘤呈多灶性发生，部分肿瘤因融合而表现为单个肿瘤。
