Itai Y, Kokubo T, Atomi Y, Kuroda A, Haraguchi Y, Terano A
Radiology. 1987 Oct;165(1):51-5. doi: 10.1148/radiology.165.1.3306789.
Five cases of prominent, diffuse dilatation of the main pancreatic duct caused by mucin-hypersecreting carcinoma are reported. Adenocarcinoma was noted mainly within one markedly dilated main pancreatic duct. On endoscopic retrograde pancreatograms, dilated main pancreatic ducts with amorphous or well-defined filling defects resulting from mucin (five patients) or tumor (one patient) were noted. The proximal portion of the main pancreatic duct alone was delineated in three cases because of reflux of contrast material as a result of the presence of excessive mucin and a patulous orifice of the papilla of Vater (major duodenal papilla). Diffuse dilatation of the main pancreatic duct was demonstrated or suggested on computed tomographic (CT) and ultrasound scans. Four patients who underwent operations are alive and free from carcinoma (mean, 50 months after diagnosis). Whenever prominent, diffuse dilatation of the main pancreatic duct is encountered on CT or ultrasound scans, endoscopic retrograde pancreatography is mandatory to permit confirmation or ruling out of mucin-hypersecreting carcinoma of the pancreas.
本文报告了5例由黏液高分泌性癌引起的主胰管显著弥漫性扩张病例。腺癌主要见于一条明显扩张的主胰管内。在内镜逆行胰胆管造影术中，可见主胰管扩张，伴有黏液（5例患者）或肿瘤（1例患者）导致的无定形或边界清晰的充盈缺损。由于存在过多黏液以及 Vater 乳头（十二指肠大乳头）开口松弛，造影剂反流，3例患者仅显示主胰管近端部分。计算机断层扫描（CT）和超声检查显示或提示主胰管弥漫性扩张。4例接受手术的患者存活且无癌（诊断后平均50个月）。当CT或超声检查发现主胰管显著弥漫性扩张时，必须进行内镜逆行胰胆管造影术，以确认或排除胰腺黏液高分泌性癌。
