Ahsan N, Berman J J
Department of Pathology, University of Maryland School of Medicine, Baltimore.
Acta Cytol. 1988 Jul-Aug;32(4):471-4.
A 54-year-old man with clinical and radiologic findings suggestive of pancreatic carcinoma had cytologic examination of bile drainage fluid specimens prepared by membrane filtration and cytocentrifugation. Examination showed clumps of malignant cells with features most consistent with a well-differentiated papillary neoplasm of bile duct origin, rather than a primary pancreatic carcinoma. Partial pancreatoduodenectomy with resection of the proximal common bile duct confirmed the presence of a small, well-differentiated but invasive papillary bile duct carcinoma. Pancreatic carcinoma and papillary carcinoma of the bile duct are anatomically and biologically different lesions that should be distinguished, when possible, by cytologic examination. In this case, surgical treatment was planned on the assumption that cytologic examination could distinguish a papillary carcinoma of the bile duct from the clinically suspected pancreatic adenocarcinoma.
一名54岁男性，临床和影像学检查结果提示胰腺癌，对经膜过滤和细胞离心制备的胆汁引流液标本进行了细胞学检查。检查显示有恶性细胞团块，其特征与起源于胆管的高分化乳头状肿瘤最为相符，而非原发性胰腺癌。行部分胰十二指肠切除术并切除近端胆总管，证实存在一个小的、高分化但侵袭性的乳头状胆管癌。胰腺癌和胆管乳头状癌在解剖学和生物学上是不同的病变，应尽可能通过细胞学检查加以区分。在本病例中，手术治疗的规划是基于细胞学检查能够将胆管乳头状癌与临床怀疑的胰腺腺癌区分开来这一假设。
