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一例伴有主胰管梗阻及FDG摄取活跃、酷似恶性胰腺肿瘤的小胰腺错构瘤:系统病例回顾

A small pancreatic hamartoma with an obstruction of the main pancreatic duct and avid FDG uptake mimicking a malignant pancreatic tumor: a systematic case review.

作者信息

Nagano Hiroaki, Nakajo Masayuki, Fukukura Yoshihiko, Kajiya Yoriko, Tani Atsushi, Tanaka Sadao, Toyota Mari, Niihara Toru, Kitazono Masaki, Suenaga Toyokuni, Yoshiura Takashi

机构信息

Departments of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan.

Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8544, Japan.

出版信息

BMC Gastroenterol. 2017 Dec 6;17(1):146. doi: 10.1186/s12876-017-0704-8.

Abstract

BACKGROUND

Pancreatic hamartomas are extremely rare and may be misdiagnosed as malignant tumors. We report herein a case of a small, solid-type pancreatic hamartoma.

CASE PRESENTATION

A 72-year-old female was incidentally detected pancreatic lesion by ultrasonography. Computed tomography and magnetic resonance imaging revealed a 2.0-cm solid lesion. The main pancreatic duct (MPD) was obstructed by the lesion in the head of the pancreas, and the upstream MPD was dilated. F-fluorodeoxyglucose (FDG) accumulated avidly in the lesion and increased in FDG intensity from the early to the delayed images. The histopathological studies confirmed the diagnosis of pancreatic hamartoma. Immunohistochemically, the cell membrane of the accessory glands and ducts showed homogeneous expression of glucose transporter type I and hexokinase II.

CONCLUSION

Pancreatic hamartomas causing dilatation of the MPD are extremely rare, and this appears to be the first case of a hamartoma to take up FDG avidly. It was a rare occurrence and should be noted that pancreatic hamartomas can cause an obstruction of the MPD and show avid FDG uptake, thereby mimicking malignant pancreatic tumors.

摘要

背景

胰腺错构瘤极为罕见,可能被误诊为恶性肿瘤。我们在此报告一例小型实性型胰腺错构瘤病例。

病例介绍

一名72岁女性通过超声意外检测到胰腺病变。计算机断层扫描和磁共振成像显示一个2.0厘米的实性病变。主胰管(MPD)被胰腺头部的病变阻塞,上游MPD扩张。氟脱氧葡萄糖(FDG)在病变中大量积聚,且从早期图像到延迟图像FDG强度增加。组织病理学研究证实为胰腺错构瘤。免疫组织化学显示,附属腺体和导管的细胞膜呈现I型葡萄糖转运蛋白和己糖激酶II的均匀表达。

结论

导致MPD扩张的胰腺错构瘤极为罕见,这似乎是首例大量摄取FDG的错构瘤。这是一种罕见情况,应注意胰腺错构瘤可导致MPD梗阻并显示大量FDG摄取,从而酷似胰腺恶性肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7353/5719573/8592cd68b40b/12876_2017_704_Fig1_HTML.jpg

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