Eggermont A, Vuzevski V, Huisman M, De Jong K, Jeekel J
J Surg Oncol. 1987 Sep;36(1):21-5. doi: 10.1002/jso.2930360106.
Primary malignant schwannoma of the pancreas is rare. The reported patient, a 40-year-old white female, presented with obstructive jaundice and a large palpable mass in the upper abdomen. A Whipple procedure was performed. Electron microscopic examination of the tumor established the Schwann cell origin of the neoplasm by demonstrating basement membranes, junctional complexes, and interdigitating cytoplasmic extensions infested with basal lamina, dense neurosecretory-like granules, and axon-like structures. The inadequacy of light microscopic examination alone for establishing the diagnosis with certainty is discussed. Review of the literature revealed only one case of a malignant schwannoma of the pancreas that was not resected. This is the first report confirmed by ultrastructural examination.
胰腺原发性恶性神经鞘瘤罕见。报告的患者为一名40岁白人女性,表现为梗阻性黄疸和上腹部可触及的巨大肿块。实施了惠普尔手术。对肿瘤进行电子显微镜检查,通过显示基底膜、连接复合体以及充满基膜、致密神经分泌样颗粒和轴突样结构的相互交错的胞质突起,确定了肿瘤的施万细胞起源。讨论了仅靠光学显微镜检查不足以确定诊断的情况。文献回顾显示,仅有一例胰腺恶性神经鞘瘤未行切除。这是首例经超微结构检查证实的报告。