Ersen Ayca, Agalar Anil Aysal, Ozer Erdener, Agalar Cihan, Unek Tarkan, Egeli Tufan, Ozbilgin Mucahit, Astarcioglu Ibrahim, Olguner Mustafa, Obuz Funda, Sagol Ozgul
Dokuz Eylul University Faculty of Medicine, Pathology Department,Izmir, Turkey.
Dokuz Eylul University Faculty of Medicine, Pathology Department,Izmir, Turkey.
Pathol Res Pract. 2016 Nov;212(11):1052-1058. doi: 10.1016/j.prp.2016.09.006. Epub 2016 Oct 21.
Solid-pseudopapillary neoplasm (SPN) is an uncommon malignant tumor of the pancreas with a favorable prognosis unlike other pancreatic neoplasms. We investigated the clinicopathological features of 20 patients with SPN in details.
The patients diagnosed as SPN in Dokuz Eylul University Hospital between January 2005 and March 2016 were reviewed in terms of clinical and histopathological data.
Mean age of the patients was 33. Three of our cases were male and 4 were children. Some patients had synchronuous malignancies. Nine patients were diagnosed by fine needle aspiration cytology (FNAC). One of our tumors had 2×1mm of pancreas endocrine neoplasm in addition to SPN. One case had foci of atypical and multinucleated giant cells. All cases were positive for vimentin and CD10 antibodies and most were positive for PR and β-catenin. The mean follow-up duration was 40 mo (range 2-110 mo). Only one case showed liver metastasis.
Herein we present a series of 20 patients with 3 male and 4 pediatric cases, almost half of which were diagnosed with FNAC findings, and most of which are clinically being followed with one patient showing progression. Our series includes rare examples like collision tumor of SPN and pancreas endocrine neoplasm, SPN with multinucleated giant cells. Also cases with no surgical treatment and no progression, as well as cases with synchronous malignancies are presented. We believe that FNAC findings of any pancreatic mass should be investigated in detail for the designation of a therapy plan especially for the patients with high operation risks. The findings in our series also show that extensive necrosis, angioinvasion, perineurial invasion and larger tumor size might be predictive for worse prognosis and these patients should be more closely followed up.
实性假乳头状肿瘤（SPN）是一种罕见的胰腺恶性肿瘤，与其他胰腺肿瘤不同，其预后良好。我们详细研究了20例SPN患者的临床病理特征。
回顾性分析2005年1月至2016年3月在多库兹艾吕尔大学医院诊断为SPN的患者的临床和组织病理学资料。
患者的平均年龄为33岁。我们的病例中有3例为男性，4例为儿童。部分患者存在同步性恶性肿瘤。9例患者通过细针穿刺细胞学检查（FNAC）确诊。我们的1例肿瘤除SPN外还伴有2×1mm的胰腺内分泌肿瘤。1例病例有非典型和多核巨细胞灶。所有病例波形蛋白和CD10抗体均呈阳性，大多数病例PR和β-连环蛋白呈阳性。平均随访时间为40个月（范围2 - 110个月）。仅1例出现肝转移。
在此我们报告了一系列20例患者，其中3例男性，4例儿童病例，几乎一半通过FNAC检查结果确诊，大多数患者目前在临床随访中，1例患者病情进展。我们的系列病例包括罕见的如SPN与胰腺内分泌肿瘤的碰撞瘤、伴有多核巨细胞的SPN等病例。还展示了未接受手术治疗且无病情进展的病例以及同步性恶性肿瘤病例。我们认为，对于任何胰腺肿块的FNAC检查结果都应详细研究，以制定治疗方案，尤其是对于手术风险高的患者。我们系列病例的研究结果还表明，广泛坏死、血管侵犯、神经周围侵犯和肿瘤体积较大可能预示预后较差，这些患者应更密切地随访。
