Clinical Department of Pathology, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Department of Internal Medicine, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan.
Clin J Gastroenterol. 2020 Dec;13(6):1373-1382. doi: 10.1007/s12328-020-01224-2. Epub 2020 Sep 10.
A woman in her 70 s was diagnosed with a tumor in her duodenal wall during a routine visit for diabetes. She subsequently underwent subtotal stomach-preserving pancreatoduodenectomy. Histologically, the tumor was present mainly in the duodenal wall, and atypical cystic ducts were seen in the muscularis propria and subserosa. Invasive well-differentiated adenocarcinoma was seen in the duodenal submucosal and mucosal layers. Heterotopic pancreatic tissue was seen within the tumor, and atypical epithelium had proliferated and replaced the cystic ductal epithelium of the heterotopic pancreas. Therefore, adenocarcinoma with intraductal papillary mucinous neoplasm arising in duodenal heterotopic pancreas was the final histopathological diagnosis, which is considered rare.
一位 70 多岁的女性在常规就诊糖尿病时被诊断出十二指肠壁有肿瘤。随后,她接受了保留胃的胰十二指肠次全切除术。组织学上,肿瘤主要存在于十二指肠壁,在肌层和浆膜下层可见非典型囊性导管。在十二指肠黏膜下层和黏膜层可见浸润性分化良好的腺癌。肿瘤内可见异位胰腺组织,异型上皮增生并取代异位胰腺的囊性导管上皮。因此,最终的组织病理学诊断为十二指肠异位胰腺内的导管内乳头状黏液性肿瘤伴腺癌,这种情况较为罕见。