Murakami Takashi, Yamazaki Masato, Yamazaki Kazuto, Matsuo Kenichi, Hirano Atsushi, Hiroshima Yukihiko, Kawaguchi Daisuke, Ishida Yasuo, Suzuki Yutaka, Sugiyama Masanori, Koda Keiji, Tanaka Kuniya
Department of Surgery, Teikyo University Chiba Medical Center, 3426-3, Anesaki, Ichihara, Chiba, 299-0011, Japan.
Department of Surgery, Teikyo University Chiba Medical Center, 3426-3, Anesaki, Ichihara, Chiba, 299-0011, Japan.
Pancreatology. 2016 May-Jun;16(3):464-8. doi: 10.1016/j.pan.2015.12.178. Epub 2016 Jan 12.
We encountered a 62-year-old female patient with a distinctive pancreatic myoepithelial hamartoma characterized by dilated loops formed by pancreatic branch ducts. The patient, who experienced recurrent acute pancreatitis caused by pancreatic juice stasis, underwent subtotal stomach-preserving pancreatoduodenectomy, achieving remission of pancreatitis. Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) demonstrated a honeycomb appearance of the pancreatic head, consisting largely of loop-forming dilated pancreatic branch ducts. Radiography of resected specimens demonstrated a tortuous main pancreatic duct that narrowed in the head, but communicated with the pancreatic branch ducts forming intricate loops within the lesion. Histologic examination showed dilated pancreatic ducts embedded in thick layers of smooth muscle, leading to a diagnosis of myoepithelial hamartoma. Her son shared a similar clinical course, radiologic findings, and histopathologic findings with his mother. MRCP demonstrated a honeycomb appearance of the pancreatic head in her daughter, who complained of persistent diarrhea. To our knowledge, this is the first English-language reports of such a myoepithelial hamartoma of the pancreas showing familial occurrence.
我们遇到了一位62岁的女性患者,其患有独特的胰腺肌上皮错构瘤,其特征为胰腺分支导管形成扩张的环。该患者因胰液淤积反复发生急性胰腺炎,接受了保留胃的胰十二指肠次全切除术,胰腺炎得以缓解。计算机断层扫描(CT)和磁共振胰胆管造影(MRCP)显示胰头呈蜂窝状外观,主要由形成环的扩张胰腺分支导管组成。切除标本的X线摄影显示主胰管迂曲,在胰头变窄,但与在病变内形成复杂环的胰腺分支导管相通。组织学检查显示扩张的胰腺导管嵌入厚层平滑肌中,从而诊断为肌上皮错构瘤。她的儿子与母亲有着相似的临床病程、影像学表现和组织病理学表现。MRCP显示她女儿的胰头呈蜂窝状外观,她女儿抱怨有持续性腹泻。据我们所知,这是首例关于胰腺肌上皮错构瘤家族性发病的英文报道。