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[主胰管内乳头状黏液性癌(胰胆管型)致胰管扩张4毫米病例]

[Case of main duct-intraductal papillary mucinous carcinoma (pancreatobiliary type) causing 4-mm dilatation of the pancreatic duct].

作者信息

Imagawa Naoto, Fukasawa Mitsuharu, Takahashi Ei, Shindo Hiroko, Takano Shinichi, Sato Tadashi, Kawaida Hiromitsu, Fujii Hideki, Nakazawa Tadao, Enomoto Nobuyuki

机构信息

First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi.

First Department of Surgery, Faculty of Medicine, University of Yamanashi.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2018;115(3):305-312. doi: 10.11405/nisshoshi.115.305.

Abstract

A 77-year-old woman with mild dilatation (4mm) of the main pancreatic duct was referred to our hospital. Contrast-enhanced computed tomography revealed segmental dilatation of the main pancreatic duct in the pancreatic tail, but no mass was noted in the pancreas. Endoscopic ultrasonography showed low papillary lesions in the dilated pancreatic duct. Cytological analysis of the pancreatic juice revealed adenocarcinoma. Distal pancreatectomy was performed for a diagnosis of main duct-intraductal papillary mucinous cancer (MD-IPMC) of the pancreatic tail. Histological findings indicated pancreatobiliary (PB)-type non-invasive IPMC. Although the patient did not meet the diagnostic criteria for intraductal papillary mucinous neoplasms (IPMNs), her final diagnosis was PB-type non-invasive IPMC. Because PB-type IPMNs display poor mucin production, pancreatic duct dilatation is sometimes mild and requires careful assessment for accurate diagnosis.

摘要

一名77岁女性,主胰管轻度扩张(4mm),转诊至我院。增强计算机断层扫描显示胰尾主胰管节段性扩张,但胰腺内未发现肿块。内镜超声显示扩张的胰管内有低乳头状病变。胰液细胞学分析显示为腺癌。因诊断为胰尾主胰管内乳头状黏液癌(MD-IPMC)行远端胰腺切除术。组织学检查结果显示为胰胆管(PB)型非侵袭性IPMC。尽管该患者不符合导管内乳头状黏液性肿瘤(IPMNs)的诊断标准,但其最终诊断为PB型非侵袭性IPMC。由于PB型IPMNs的黏液分泌较少,胰管扩张有时较轻,需要仔细评估以准确诊断。

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