Son Jun Hyuk, Park Hye Kyeong, Kim Han-Seong, Kim Nam-Hoon, Kim Jung Wook, Bae Won Ki, Kim Kyung-Ah, Lee June Sung, Lee Yoon Suk
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
Diagn Cytopathol. 2018 Nov;46(11):977-980. doi: 10.1002/dc.23990. Epub 2018 Oct 24.
Pancreatic metastasis is extremely rare, particularly from small-cell lung cancer (SCLC). Studies on the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with liquid-based cytology (LBC) in the diagnosis of metastatic small-cell carcinoma in the pancreas have been rarely conducted. We report herein a case of pancreatic metastasis from SCLC diagnosed using EUS-FNA with LBC (ThinPrep). A 71-year-old man presented with chief complaints of hemoptysis and jaundice over the past 1 month. Lung & pancreas tumors with multiple liver nodules were detected on computed tomography. The aspirated material from the pancreas using EUS-FNA was prepared as a cytologic specimen with ThinPrep method, which revealed scattered and clustered "small blue cells" with scant cytoplasm and stippled chromatin with frequent apoptotic bodies. Immunocytochemical staining of the cellblock material revealed strong positivity for CD56 and thyroid transcription factor-1. Endobronchial biopsy for lung mass revealed nests of small, round, blue tumor cells with hyperchromatic nuclei showing salt and pepper chromatin, scant cytoplasm, and brisk mitotic activity. Therefore, a diagnosis of metastatic small-cell carcinoma to the pancreas with an extensive stage was finally made.
胰腺转移极为罕见，尤其是来自小细胞肺癌（SCLC）的转移。关于内镜超声引导下细针穿刺抽吸术（EUS-FNA）联合液基细胞学检查（LBC）在胰腺转移性小细胞癌诊断中的作用的研究很少。我们在此报告一例通过EUS-FNA联合LBC（ThinPrep）诊断的SCLC胰腺转移病例。一名71岁男性，过去1个月主要症状为咯血和黄疸。计算机断层扫描发现肺部和胰腺有肿瘤，肝脏有多个结节。使用EUS-FNA从胰腺获取的抽吸物采用ThinPrep方法制备成细胞学标本，显示有散在和成簇的“小蓝细胞”，胞质稀少，染色质呈点彩状，有频繁的凋亡小体。细胞块材料的免疫细胞化学染色显示CD56和甲状腺转录因子-1呈强阳性。对肺部肿块进行支气管内活检，发现小的、圆形的蓝色肿瘤细胞巢，核深染，染色质呈椒盐状，胞质稀少，有活跃的有丝分裂活动。因此，最终诊断为广泛期胰腺转移性小细胞癌。
