Sakane Tatsuya, Iemoto Takao, Inoue Yuta, Abe Tetsuyuki, Futai Ryoko, Hayashi Hiroki, Yoshie Tomoo, Yamamoto Yuki, Ose Takayuki
Department of Gastroenterology, Kita-Harima Medical Center.
Department of Pathology, Kita-Harima Medical Center.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(9):858-867. doi: 10.11405/nisshoshi.119.858.
A 57-year-old man with fatigue was admitted to our hospital. Abdominal contrast computed tomography indicated the presence of a 35mm tumor in the pancreatic head and dilation of the main pancreatic duct from its body to the tail. Endoscopic ultrasonography revealed that the tumor had infiltrated and occupied the main pancreatic duct, and endoscopic retrograde pancreatography confirmed that the tumor was present in the main pancreatic duct. Tumor biopsy via endoscopic retrograde cholangiopancreatography demonstrated the proliferation of spindle and pleomorphic cells. Therefore, the patient was diagnosed with anaplastic pancreatic carcinoma and underwent subtotal stomach-preserving pancreaticoduodenectomy. Histological analysis showed the prevalence of adenocarcinoma and anaplastic carcinoma cells in the pancreatic parenchyma and main pancreatic duct, respectively. Anaplastic carcinoma cells showed a decrease in E-cadherin staining. In conclusion, tumor cell proliferation and lack of cell adhesion may have caused the infiltration into the main pancreatic duct.
一名57岁疲劳男性入住我院。腹部增强计算机断层扫描显示胰头有一个35毫米的肿瘤,主胰管从胰体至胰尾扩张。内镜超声检查显示肿瘤已浸润并占据主胰管,内镜逆行胰胆管造影证实肿瘤存在于主胰管内。通过内镜逆行胰胆管造影进行肿瘤活检显示梭形细胞和多形性细胞增生。因此,该患者被诊断为间变性胰腺癌,并接受了保留部分胃的胰十二指肠切除术。组织学分析显示,腺癌和间变性癌细胞分别在胰腺实质和主胰管中占优势。间变性癌细胞E-钙黏蛋白染色减少。总之,肿瘤细胞增殖和细胞黏附缺失可能导致了对主胰管的浸润。