Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan.
Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Clin J Gastroenterol. 2020 Oct;13(5):951-958. doi: 10.1007/s12328-020-01136-1. Epub 2020 Jun 11.
Mixed acinar-neuroendocrine carcinoma (MAEC) of the pancreas is a rare entity, and obtaining a preoperative diagnosis is difficult. We report a case of pancreatic MAEC successfully diagnosed with EUS-FNA. The case was a 72-year-old male with upper abdominal pain. Abdominal CT showed an irregular, hypovascular tumor of pancreatic tail. EUS-FNA was performed using a 22G needle. Immunostaining revealed positive results for the acinar marker trypsin and the neuroendocrine markers chromogranin A and synaptophysin. The possibility for MAEC was considered. He underwent distal pancreatectomy and splenectomy. Immunohistochemical examination of the tumor cells showed a wide range of positivity for bcl-10 and trypsin as well as for chromogranin A and synaptophysin, but negative results for CA19-9 and AFP. Considering that ≥ 30% tumors were positive for both acinar and neuroendocrine markers, the patient was diagnosed with MAEC.
胰腺混合性腺神经内分泌癌（MAEC）是一种罕见的实体瘤，术前诊断较为困难。我们报告了一例通过 EUS-FNA 成功诊断的胰腺 MAEC 病例。该病例为 72 岁男性，表现为上腹痛。腹部 CT 显示胰尾不规则、低血供肿瘤。使用 22G 针进行 EUS-FNA。免疫组化染色显示腺泡标志物胰蛋白酶和神经内分泌标志物嗜铬粒蛋白 A 和突触素阳性。考虑 MAEC 的可能性。他接受了胰尾切除术和脾切除术。肿瘤细胞的免疫组织化学检查显示 bcl-10 和胰蛋白酶以及嗜铬粒蛋白 A 和突触素广泛阳性，但 CA19-9 和 AFP 阴性。考虑到≥30%的肿瘤同时对腺泡和神经内分泌标志物呈阳性，患者被诊断为 MAEC。
