Zeng Jennifer, Simsir Aylin, Oweity Thaira, Hajdu Cristina, Cohen Steven, Shi Yan
Department of Pathology, New York University Langone Medical Center, New York, New York.
Department of Surgery, New York University Langone Medical Center, New York, New York.
Diagn Cytopathol. 2017 Oct;45(10):947-952. doi: 10.1002/dc.23761. Epub 2017 May 30.
Cytologic diagnosis of extra-adrenal paraganglioma presenting as a peripancreatic mass is challenging with a high error rate due to its rarity. We report two cases of peripancreatic masses identified by radiology. Endoscopic ultrasound-guided fine needle aspiration (FNA) of the masses showed a moderately cellular tumor composed of small to medium sized neoplastic cells with round to oval nuclei, arranged singly and in loose clusters. Focal rosette-like structures were present. The cells were positive for neuroendocrine markers (synaptophysin and chromogranin). A diagnosis of a neoplasm with neuroendocrine differentiation and neuroendocrine tumor was made respectively on FNA for each case. The subsequent surgical resection of the tumors revealed peripancreatic paraganglioma. Although paraganglioma has been reported in the literature, the detailed comparison of perpancreatic paraganglioma versus pancreatic/gastrointestinal neuroendocrine tumor is still lacking. Therefore using these two cases with literature review, we wish to illustrate the differential diagnosis between these two entities based on cytomorphology and immunohistochemical study.
因肾上腺外副神经节瘤罕见，表现为胰周肿块时进行细胞学诊断具有挑战性，误诊率高。我们报告两例经放射学检查发现的胰周肿块病例。对肿块进行内镜超声引导下细针穿刺抽吸（FNA），显示肿瘤细胞中等丰富，由小至中等大小的肿瘤细胞组成，细胞核圆形至椭圆形，单个或呈松散簇状排列。可见局灶性玫瑰花结样结构。细胞神经内分泌标志物（突触素和嗜铬粒蛋白）呈阳性。每例FNA均诊断为神经内分泌分化肿瘤及神经内分泌瘤。随后对肿瘤进行手术切除，结果显示为胰周副神经节瘤。虽然文献中已有副神经节瘤的报道，但胰周副神经节瘤与胰腺/胃肠道神经内分泌肿瘤的详细比较仍较缺乏。因此，我们通过这两例病例并结合文献复习，希望基于细胞形态学和免疫组化研究阐述这两种实体之间的鉴别诊断。
