Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.
Int J Surg Pathol. 2024 Apr;32(2):422-427. doi: 10.1177/10668969231183635. Epub 2023 Jul 2.
Enteric duplication cysts are rare but can occur in various parts of the gastrointestinal tract, including the pancreas. Most enteric duplication cysts are benign; however, neoplastic transformation has been reported in a few cases, with adenocarcinoma being the most common malignant transformation. We present an adult with a pancreatic enteric duplication cyst and low-grade mucinous neoplasm. The patient did not exhibit any clinically significant symptoms or physical signs. Imaging revealed a cystic mass in the pancreatic head. Upon pathological examination, the cyst was found to have a bilayered muscular wall with an inner surface lined with pseudostratified mucinous columnar epitheliums. High-power microscopy revealed low-grade dysplasia in epithelial cells. The final pathological diagnosis confirmed an enteric duplication cyst with a low-grade mucinous neoplasm. To the best of our knowledge, this is the first reported case of a low-grade mucinous neoplasm occurring in an enteric duplication cyst in the pancreas. The importance of complete surgical resection and adequate pathological sampling is emphasized to avoid the missed detection of dysplasia or malignancy in these duplication cysts.
肠源性重复囊肿较为罕见，但可发生于胃肠道的各个部位，包括胰腺。大多数肠源性重复囊肿为良性；然而，少数病例有肿瘤性转化，其中腺癌为最常见的恶性转化。我们报告了一例胰腺肠源性重复囊肿伴低级别黏液性肿瘤的成年患者。该患者无明显临床症状或体征。影像学检查显示胰腺头部有囊性肿块。病理检查发现囊肿具有双层肌壁，内表面衬有假复层黏液柱状上皮。高倍显微镜下显示上皮细胞存在低级别异型增生。最终的病理诊断证实为肠源性重复囊肿伴低级别黏液性肿瘤。据我们所知，这是首例报道的胰腺肠源性重复囊肿伴低级别黏液性肿瘤。强调完整手术切除和充分的病理取样的重要性，以避免这些重复囊肿中异型增生或恶性肿瘤的漏诊。
