Department of Pathology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India.
Indian J Cancer. 2024 Apr 1;61(2):415-417. doi: 10.4103/ijc.ijc_679_21. Epub 2024 Jul 16.
A 40-year-old woman presented with dull, boring periumbilical region pain radiating to the back and vomiting for 1 year. Magnetic resonance cholangiopancreatography detected a polypoid growth in the ampullary region. The patient underwent Whipple's procedure. The specimen revealed a 4.9 × 4.5 × 3.7 cm tumor arising from the pancreas, abutting the posterior pancreatic surface and infiltrating the terminal common bile duct and the ampulla. Microscopic examination showed a pancreatic tumor composed of neuroendocrine cells. In addition, many large foci showing solid sheets of oncocytic cells with abundant granular eosinophilic cytoplasm were observed. Immunohistochemistry studies revealed positivity for synaptophysin, chromogranin, and Ki67 index above 70%. A diagnosis of oncocytic neuroendocrine tumor of Grade 3 was made. In electron microscopy, oncocytic cells showed abundant mitochondria dispersed throughout the cytoplasm. Oncocytic pancreatic neuroendocrine neoplasms are uncommon and can be diagnosed only on histopathological examination. These tumors tend to show a malignant behavior.
一位 40 岁女性因脐周钝痛、闷痛伴放射至背部及呕吐 1 年就诊。磁共振胆胰管成像发现壶腹部有一息肉样生长。患者行胰十二指肠切除术。标本显示胰腺有一 4.9×4.5×3.7cm 的肿瘤，与胰腺后表面相邻，浸润末端胆总管和壶腹。镜下检查显示胰腺肿瘤由神经内分泌细胞组成。此外，还观察到许多大灶表现为富含嗜酸性颗粒的实性片状细胞，为嗜酸性细胞。免疫组化研究显示突触素、嗜铬粒蛋白阳性，Ki67 指数高于 70%。诊断为 3 级嗜酸细胞性神经内分泌肿瘤。电镜下，嗜酸性细胞显示大量散在分布于细胞质中的线粒体。嗜酸细胞性胰腺神经内分泌肿瘤并不常见，只能通过组织病理学检查诊断。这些肿瘤往往表现出恶性行为。
