Kim Minjeong, Park Jin Myung, Lee Sung Joon, Kang Chang Don, Kang MyungHo, Kim Ji Hyun, Lee Seungkoo, Cho Seong Whi
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Department of Anatomic Pathology, Kangwon National University School of Medicine, Chuncheon, Korea.
Korean J Gastroenterol. 2018 Feb 25;71(2):98-102. doi: 10.4166/kjg.2018.71.2.98.
We report a case of acute pancreatitis secondary to pancreatic neuroendocrine tumor. A 46-year old man presented with upper abdominal pain. The serum amylase and lipase were elevated. Abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a 1.7 cm sized mass at the pancreas body with a dilatation of the upstream pancreatic duct and mild infiltrations of peripancreatic fat. An endoscopic ultrasound-guided fine needle biopsy was performed for the pancreatic mass, but only necrotic tissue was observed on the pathologic examination. A chest and neck CT scan revealed anterior mediastinal, paratracheal, and cervical lymph node enlargement, which were indicative of metastasis. An ultrasound-guided core needle biopsy was performed for the enlarged neck lymph node, and pathologic examination revealed a metastatic poorly differentiated carcinoma. Immunohistochemical analysis showed positive staining for synaptophysin, chromogranin A, and CD 56, indicative of a neuroendocrine carcinoma.
我们报告一例继发于胰腺神经内分泌肿瘤的急性胰腺炎病例。一名46岁男性因上腹部疼痛就诊。血清淀粉酶和脂肪酶升高。腹部计算机断层扫描（CT）和磁共振胰胆管造影显示胰体部有一个1.7厘米大小的肿块，上游胰管扩张，胰周脂肪轻度浸润。对胰腺肿块进行了内镜超声引导下细针穿刺活检，但病理检查仅观察到坏死组织。胸部和颈部CT扫描显示前纵隔、气管旁和颈部淋巴结肿大，提示有转移。对肿大的颈部淋巴结进行了超声引导下粗针穿刺活检，病理检查显示为转移性低分化癌。免疫组化分析显示突触素、嗜铬粒蛋白A和CD 56呈阳性染色，提示为神经内分泌癌。
