Matsubayashi Hiroyuki, Kaneko Junichi, Sato Junya, Satoh Tatsunori, Ishiwatari Hirotoshi, Sugiura Teichi, Ashida Ryo, Uesaka Katsuhiko, Sasaki Keiko, Ono Hiroyuki
Division of Endoscopy, Shizuoka Cancer Center, Japan.
Division of Hepato-pancreaticobiliary Surgery, Shizuoka Cancer Center, Japan.
Intern Med. 2019 Dec 15;58(24):3545-3550. doi: 10.2169/internalmedicine.3271-19. Epub 2019 Aug 28.
Osteoclast-like giant cell-type (OCGC) anaplastic carcinoma is a rare variant of pancreatic ductal adenocarcinoma, and its imaging characteristics and progression pattern have not been fully clarified. The patient was a 73-year-old man who had been incidentally found to have a pancreatic head tumor. Computed tomography demonstrated a 3-cm marginally enhanced mass at the pancreatic head, continuing toward the duodenum. Diffusion-weighted magnetic resonance imaging showed a retained diffusion capacity. Duodenoscopy revealed a 1.5-cm polypoid lesion, covered by a dirty coat, near the major papilla. Surgical material revealed OCGC pancreatic anaplastic carcinoma protruding to the duodenum, accompanied by multiple hemorrhagic foci and hemosiderin precipitations.
破骨细胞样巨细胞型(OCGC)间变性癌是胰腺导管腺癌的一种罕见变体,其影像学特征和进展模式尚未完全阐明。该患者为一名73岁男性,偶然发现胰头肿瘤。计算机断层扫描显示胰头有一个3厘米的边缘强化肿块,延伸至十二指肠。扩散加权磁共振成像显示扩散能力保留。十二指肠镜检查发现主乳头附近有一个1.5厘米的息肉样病变,表面有污秽物覆盖。手术材料显示OCGC胰腺间变性癌突出至十二指肠,伴有多个出血灶和含铁血黄素沉着。