Noda Eiji, Kuroda Kenji, Sera Tomohisa, Mori Takuya, Kinoshita Haruhito, Hasegawa Tsuyoshi, Teraoka Hitoshi, Chikugo Takaaki
Department of Surgery, Pegasus-Baba Memorial Hospital, Sakai-shi, Osaka, Japan.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Surg Case Rep. 2018 Aug 4;2018(8):rjy181. doi: 10.1093/jscr/rjy181. eCollection 2018 Aug.
We report a case of intraductal papillary mucinous neoplasm arising within the heterotopic pancreatic tissue which was found incidentally in the jejunum during surgery for bowel obstruction. A 54-year-old female patient was admitted to our hospital due to sudden abdominal pain. In preoperative findings, we diagnosed bowel obstruction and performed surgery. Intra-operative findings showed adhesive intestinal obstruction, we performed synechiotomy for adhesion release. During surgery, when searching the small intestine, we coincidentally found a tumor in the jejunum and partial resected the jejunum. Pathological examination revealed a 1.2 cm × 1.0 cm × 1.0 cm white yellow nodule with cystic spaces. Histological examination demonstrated heterotopic pancreatic tissue consisting of well-formed lobules of pancreatic acini and cystically dilated ducts containing intraductal papillary neoplasm. Moreover, in immunohistochemical staining, MUC5AC was diffusely expressed, but not MUC1, MUC2 and MUC6.
我们报告了一例发生在异位胰腺组织内的导管内乳头状黏液性肿瘤,该肿瘤在肠梗阻手术期间于空肠中偶然发现。一名54岁女性患者因突发腹痛入院。术前检查发现,我们诊断为肠梗阻并进行了手术。术中发现为粘连性肠梗阻,我们进行了粘连松解术。手术过程中,在探查小肠时,我们偶然在空肠中发现一个肿瘤,并对空肠进行了部分切除。病理检查显示一个1.2 cm×1.0 cm×1.0 cm的黄白色结节,有囊腔。组织学检查显示异位胰腺组织由结构良好的胰腺腺泡小叶和含有导管内乳头状肿瘤的囊性扩张导管组成。此外,免疫组化染色显示,MUC5AC呈弥漫性表达,而MUC1、MUC2和MUC6未表达。