Hirabayashi Kenichi, Saika Tsubasa, Nakamura Naoya
Department of Pathology Tokai University School of Medicine Kanagawa Japan.
Diagnostic Pathology Center Tokai University Hospital Kanagawa Japan.
DEN Open. 2022 Mar 23;2(1):e105. doi: 10.1002/deo2.105. eCollection 2022 Apr.
Cytology is a useful method for diagnosing pancreatic neoplasms. Although endoscopic ultrasound-guided fine-needle aspiration has recently become the mainstream method for the diagnosis of pancreatic neoplasms, pancreatic juice and pancreatic duct brushing cytology continue to be useful diagnostic methods for the investigation of pancreatic neoplasms. Diagnoses using pancreatic cytology are primarily based on the features related to tumor cells; however, evaluation of the background features provides important information that could further aid the diagnosis. Pancreatic neoplasms show various histological types, each of which is associated with its own characteristic background features. The necrotic background, desmoplastic stroma, and presence of cancer-associated fibroblasts are background features of pancreatic ductal adenocarcinoma, a mucinous background is associated with intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, and hyaline globules are observed in solid pseudopapillary neoplasms. However, some background features are associated with more than one histological type of pancreatic neoplasm, highlighting the importance to base a diagnosis on the results of a comprehensive analysis of not only the background features but also the tumor cells. Here, we provide a review of the key background cytological features of pancreatic neoplasms, which can serve as a guide to improve diagnosis and research.
细胞学是诊断胰腺肿瘤的一种有用方法。尽管内镜超声引导下细针穿刺最近已成为诊断胰腺肿瘤的主流方法，但胰液和胰管刷检细胞学仍是用于胰腺肿瘤研究的有用诊断方法。胰腺细胞学诊断主要基于肿瘤细胞的特征；然而，对背景特征的评估提供了可进一步辅助诊断的重要信息。胰腺肿瘤表现出多种组织学类型，每种类型都有其自身独特的背景特征。坏死背景、促纤维增生性间质以及癌相关成纤维细胞的存在是胰腺导管腺癌的背景特征，黏液背景与导管内乳头状黏液性肿瘤和黏液性囊性肿瘤相关，而在实性假乳头状肿瘤中可观察到透明小球。然而，一些背景特征与不止一种组织学类型的胰腺肿瘤相关，这凸显了不仅要基于背景特征，还要基于肿瘤细胞的综合分析结果进行诊断的重要性。在此，我们对胰腺肿瘤关键的背景细胞学特征进行综述，这可作为提高诊断和研究水平的指南。
