胰腺的恶性上皮/外分泌肿瘤。
Malignant epithelial/exocrine tumors of the pancreas.
机构信息
Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy.
Anatomic Pathology, San Martino IRCCS Hospital, Genova, Italy.
出版信息
Pathologica. 2020 Sep;112(3):210-226. doi: 10.32074/1591-951X-167.
Pancreatic malignant exocrine tumors represent the most important cause of cancer-related death for pancreatic neoplasms. The most common tumor type in this category is represented by pancreatic ductal adenocarcinoma (PDAC), an ill defined, stroma-rich, scirrhous neoplasm with glandular differentiation. Here we present the relevant characteristics of the most important PDAC variants, namely adenosquamous carcinoma, colloid carcinoma, undifferentiated carcinoma, undifferentiated carcinoma with osteoclast-like giant cells, signet ring carcinoma, medullary carcinoma and hepatoid carcinoma. The other categories of malignant exocrine tumors, characterized by fleshy, stroma-poor, circumscribed neoplasms, include acinar cell carcinoma (pure and mixed), pancreatoblastoma, and solid pseudopapillary neoplasms. The most important macroscopic, histologic, immunohistochemical and molecular hallmarks of all these tumors, highlighting their key diagnostic/pathological features are presented. Lastly, standardized indications regarding gross sampling and how to compile a formal pathology report for pancreatic malignant exocrine tumors will be provided.
胰腺恶性外分泌肿瘤是胰腺肿瘤相关死亡的最重要原因。此类疾病中最常见的肿瘤类型是胰腺导管腺癌(PDAC),一种界限不清、富含基质、硬癌样的具有腺体分化的肿瘤。本文介绍了 PDAC 最重要的变异型(腺鳞癌、胶样癌、未分化癌、伴有破骨样巨细胞的未分化癌、印戒细胞癌、髓样癌和肝样癌)的相关特征。其他以肉质、基质贫乏、界限清楚的肿瘤为特征的恶性外分泌肿瘤包括腺泡细胞癌(纯合型和混合型)、胰母细胞瘤和实性假乳头状肿瘤。所有这些肿瘤的最重要的宏观、组织学、免疫组织化学和分子特征,突出了它们的关键诊断/病理特征。最后,将提供关于胰腺恶性外分泌肿瘤大体采样的标准化指示以及如何编写正式病理报告。