Utsumi Masashi, Umeda Yuzo, Takagi Kosei, Takashi Kuise, Nobuoka Daisuke, Yoshida Ryuichi, Shinoura Susumu, Sadamori Hiroshi, Yagi Takahito, Fujiwara Toshiyoshi
Hepatogastroenterology. 2015 Mar-Apr;62(138):441-6.
BACKGROUND/AIMS: Pancreatic neuroendocrine tumors (PNET) are relatively rare. Here, we present clinical and pathological characteristics of PNETs to show a relationship between computed tomography (CT) imaging and the 2010 World Health Organization (WHO) classification.
We retrospectively reviewed the records of 41 PNET patients who were treated between 2002 and 2012. All tumors were classified as neuroendocrine tumor (NET) grade 1 (G1), NET grade 2 (G2), or neuroendocrine carcinoma (NEC) grade 3 (G3) on the basis of the 2010 WHO classification system.
Twenty-five tumors were classified as G1, 11 as G2, and five as G3. Mean sizes of the G1, G2 and G3 tumors were 1.84 ± 0.54, 4.90 ± 0.84, and 5.62 ± 1.18 cm, respectively, (P < 0.01). A PNET is typically hypervascular and exhibits contrast enhancement on enhanced CT. Higher percentage of G1 tumors demonstrated typical imaging and showed a significantly greater distinct mass compared with G2 and G3 tumors.
Although PNET has many imaging features that appear on CT, G2 and G3 tumors often show atypical imaging features, particularly with large sizes and/or ill-defined features, when compared with G1 tumors. If a PNET has atypical imaging features, possibility of malignancy should be considered.
背景/目的：胰腺神经内分泌肿瘤（PNET）相对罕见。在此，我们展示PNET的临床和病理特征，以揭示计算机断层扫描（CT）成像与2010年世界卫生组织（WHO）分类之间的关系。
我们回顾性分析了2002年至2012年间接受治疗的41例PNET患者的记录。根据2010年WHO分类系统，所有肿瘤均被分类为神经内分泌瘤（NET）1级（G1）、NET 2级（G2）或神经内分泌癌（NEC）3级（G3）。
25个肿瘤被分类为G1，11个为G2，5个为G3。G1、G2和G3肿瘤的平均大小分别为1.84±0.54、4.90±0.84和5.62±1.18 cm，（P<0.01）。PNET通常血供丰富，在增强CT上表现为对比增强。与G2和G3肿瘤相比，更高比例的G1肿瘤表现出典型的影像学特征，且肿块边界明显更清晰。
尽管PNET在CT上有许多影像学特征，但与G1肿瘤相比，G2和G3肿瘤常表现出非典型的影像学特征，尤其是肿瘤较大和/或边界不清时。如果PNET具有非典型的影像学特征，应考虑恶性的可能性。
