Egami Takatoshi, Yamada Takanori, Matsuura Tomoharu, Tsuji Atsushi, Takahashi Yurimi, Sasada Yuzo, Ochiai Hideto, Suzuki Shohachi, Suzuki Shioto, Saida Yasuhiko
Department of Gastroenterology, Iwata City Hospital.
Department of Surgery, Iwata City Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2017;114(5):881-888. doi: 10.11405/nisshoshi.114.881.
An asymptomatic pancreatic tumor was discovered in a 77-year-old man during a medical check-up. An abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a cystic mass containing a septum-like solid portion in the head of the pancreas, measuring 3.5cm in diameter. Additionally, abdominal contrast-enhanced ultrasonography (US) revealed increased flow in the solid portion and a tumor capsule in its early phase. We preoperatively diagnosed the lesion as a cystic-degenerated pancreatic neuroendocrine tumor or solid-pseudopapillary tumor and performed a pancreatoduodenectomy. Histopathological examination revealed a cystic pancreatic mass consisting of spindle-shaped cells, with S-100-positive and SMA-negative immunohistochemical stainings. This lesion was diagnosed as a pancreatic schwannoma from these findings.
一名77岁男性在体检时发现了一个无症状胰腺肿瘤。腹部计算机断层扫描（CT）和磁共振成像（MRI）显示胰腺头部有一个囊性肿块，其中包含一个类似隔膜的实性部分，直径为3.5厘米。此外，腹部对比增强超声检查（US）显示实性部分血流增加，早期可见肿瘤包膜。我们术前将该病变诊断为囊性退变的胰腺神经内分泌肿瘤或实性假乳头状肿瘤，并进行了胰十二指肠切除术。组织病理学检查显示，该囊性胰腺肿块由梭形细胞组成，免疫组化染色S-100阳性、平滑肌肌动蛋白（SMA）阴性。根据这些发现，该病变被诊断为胰腺神经鞘瘤。
