Zheng Xingju, Tan Xianzheng, Wu Bing
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2014 Feb;31(1):107-12.
To analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP), and correlation with the pathological findings of the disease so as to improve the diagnostic abilities, the CT images and the clinical manifestations, we retrospectively analyzed the pathological materials of 23 cases with surgery and pathology proved SPTP. In the 23 patients, 21 cases were female (91.3%) and 2 were male (8.7%). The most common symptom was abdominal discomfort with dull pain in 12 patients (52.2%). Others included the pancreatic mass that was detected incidentally during physical examination in 9 patients (39.1%), nausea/vomiting in 2 patients (8.7%). And 1 case of female patients had 2 lesions. In the 24 tumors, 6 cases were located at the head (25.0%), 3 were at neck (12.5%), 8 cases were at body (33.3%), and 7 cases were at tail of pancreas respectively (29.2%). The long-axis diameter ranged from 2.1 cm to 20.1 cm (mean 6.4 cm). 9 tumors were mostly solid component (37.5%), 10 tumors were contained similar proportion of solid and cystic part (41.7%), and mainly cystic components in 5 tumors (20.8%). In 9 of the 23 patients, calcification was found in the tumor (39.1%). In 2 of the 23 patients, bleeding was seen in the mass (8.7%). The dilation of intrahepatic bile duct was found in 1 patient (8.7%). Liver metastasis was showed in one patient (8.7%). On post-contrast CT scan, solid parts demonstrated mild enhancement at the arterial phase. At the portal phase, solid parts were enhanced continuously in all cases, and the enhancement degrees were lower than normal pancreatic tissue. The cystic parts of all lesions showed no enhancement. Pseudo papillary structure, hemorrhage, necrosis, or cystic degeneration were found in all patients by histological study. In a word, SPTP has comparatively characteristic CT imaging features consistent with histological features, when combined with clinical manifestations, could be correctly diagnosed and differentially diagnosed.
分析胰腺实性假乳头状瘤(SPTP)的CT特征及其与疾病病理表现的相关性,以提高诊断能力,回顾性分析23例经手术及病理证实为SPTP患者的CT图像及临床表现与病理资料。23例患者中,女性21例(91.3%),男性2例(8.7%)。最常见症状为腹部不适伴钝痛12例(52.2%)。其他包括9例(39.1%)体检时偶然发现胰腺肿块,2例(8.7%)恶心/呕吐。1例女性患者有2个病灶。24个肿瘤中,6例位于胰头(25.0%),3例位于胰颈(12.5%),8例位于胰体(33.3%),7例位于胰尾(29.2%)。长径范围为2.1 cm至20.1 cm(平均6.4 cm)。9个肿瘤以实性成分居多(37.5%),10个肿瘤实性与囊性部分比例相近(41.7%),5个肿瘤以囊性成分为主(20.8%)。23例患者中9例(39.1%)肿瘤内见钙化。23例患者中2例(8.7%)肿块内见出血。1例患者(8.7%)见肝内胆管扩张。1例患者(8.7%)有肝转移。CT增强扫描动脉期实性部分呈轻度强化。门静脉期所有病例实性部分持续强化,强化程度低于正常胰腺组织。所有病灶的囊性部分均无强化。组织学研究发现所有患者均有假乳头状结构、出血、坏死或囊性变。总之,SPTP具有比较特征性的CT影像表现,与组织学特征相符,结合临床表现可作出正确诊断及鉴别诊断。