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壶腹周围腺癌类癌:诊断困境

Periampullary adenocarcinoid: diagnostic dilemma.

作者信息

Krishnappa Rashmi, Metikurke Sudha Horakerappa, Honnappa Sridhar, Hosakote Rudresh, Chandrashekar Nagesh Kumar Talkad

机构信息

Department of Pathology, M S Ramaiah Medical College and Teaching Hospital, Bangalore, India.

Department of General Surgery, M S Ramaiah Medical College and Teaching Hospital, Bangalore, India.

出版信息

J Lab Physicians. 2013 Jul;5(2):139-41. doi: 10.4103/0974-2727.119875.

Abstract

The growth in periampullary region needs proper evaluation as they can arise from duodenum, pancreas and extra hepatic biliary tree. We have reported a case of adenocarcinoid of duodenum presenting as periampullary growth with obstructive jaundice. Histologically, tumor displayed biphasic pattern, i.e. tubuloglandular architecture with admixed sheets of neuroendocrine cells without pancreas and extra hepatic biliary tree involvement. The adenocarcinoids are of great diagnostic challenges for the pathologist interpreting endoscopic biopsy for the frequent misinterpretation as negative due to their submucosal location or as adenocarcinomas due to tubulo-glandular architecture.

摘要

壶腹周围区域的肿物需要进行恰当评估,因为它们可能起源于十二指肠、胰腺和肝外胆管树。我们报告了一例十二指肠腺类癌,表现为壶腹周围肿物并伴有梗阻性黄疸。组织学上,肿瘤呈现双相模式,即具有管状腺泡结构,同时混有神经内分泌细胞片层,且未累及胰腺和肝外胆管树。对于病理学家而言,腺类癌在解读内镜活检时极具诊断挑战,因为其位于黏膜下层,常被误判为阴性,又因其管状腺泡结构而常被误诊为腺癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79ca/3968628/44dc3bc7d13b/JLP-5-139-g001.jpg

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