Banner B F, Myrent K L, Memoli V A, Gould V E
Acta Cytol. 1985 May-Jun;29(3):442-8.
Cytologic criteria for distinguishing endocrine from exocrine carcinomas of the pancreas have not been previously elucidated. A case is presented in which the diagnosis of neuroendocrine carcinoma was made on fine needle aspirates of a pancreatic mass and hepatic metastases in a 33-year-old female. Cytologically, the aspirated tumor resembled an intermediate-cell neuroendocrine carcinoma of the lung rather than the usual duct-cell adenocarcinoma of the pancreas. Histologic sections of the subsequently resected primary pancreatic mass revealed a neuroendocrine carcinoma of an intermediate-cell type. Ultrastructurally, the characteristic interlacing cytoplasmic processes with scanty granules were seen. Immunoreactive neuron-specific enolase (NSE), leuenkephalin, substance P and somatostatin were present in the tumor cells in Bouin's-fixed cell blocks of the aspirate; neuron-specific enolase, somatostatin and gastrin were detected in the paraffin-embedded sections of the resected tumor. This variant of pancreatic carcinoma merits recognition as a cytologically distinct group, which shares many of the features described in its bronchopulmonary and gastrointestinal counterparts.
此前尚未阐明鉴别胰腺内分泌癌与外分泌癌的细胞学标准。本文报告一例33岁女性，通过胰腺肿块及肝转移灶的细针穿刺抽吸物诊断为神经内分泌癌。细胞学上，抽吸的肿瘤类似于肺的中间细胞神经内分泌癌，而非胰腺常见的导管细胞腺癌。随后切除的原发性胰腺肿块的组织学切片显示为中间细胞型神经内分泌癌。超微结构上，可见特征性的交织状胞质突起及少量颗粒。在抽吸物的Bouin固定细胞块中，肿瘤细胞存在免疫反应性神经元特异性烯醇化酶（NSE）、亮脑啡肽、P物质和生长抑素；在切除肿瘤的石蜡包埋切片中检测到神经元特异性烯醇化酶、生长抑素和胃泌素。这种胰腺癌变体值得被视为一个细胞学上独特的群体，它具有许多在支气管肺和胃肠道对应物中描述的特征。
