• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

一例生长于胰管内的胰腺导管腺癌，酷似导管内管状乳头状肿瘤。

A case of pancreatic ductal adenocarcinoma growing within the pancreatic duct mimicking an intraductal tubulopapillary neoplasm.

作者信息

Sato Ryosuke, Matsumoto Kazuyuki, Uka Mayu, Takagi Kosei, Nishida Kenji, Tanaka Takehiro, Fujii Yuki, Tsutsumi Koichiro, Horiguchi Shigeru, Otsuka Motoyuki

机构信息

Department of Gastroenterology and Hepatology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.

Department of Radiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.

出版信息

Clin J Gastroenterol. 2025 Apr;18(2):376-382. doi: 10.1007/s12328-025-02098-y. Epub 2025 Feb 5.

DOI:10.1007/s12328-025-02098-y
PMID:39910028
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922994/
Abstract

We herein report a case of pancreatic ductal adenocarcinoma (PDAC) that developed within the pancreatic duct and was initially diagnosed as an intraductal tubulopapillary neoplasm (ITPN). A 76-year-old man presented with weight loss and main pancreatic duct dilation. The imaging studies revealed a 30-mm hypovascular tumor within the main duct of the pancreatic head. An endoscopic examination with a biopsy revealed high-grade atypical epithelial cells with immunostaining patterns suggestive of ITPN. Following robot-assisted pancreaticoduodenectomy, postoperative pathology revealed conflicting features: nodular/cribriform infiltrations typical of ITPN and non-lobular replacement with scattered infiltrations characteristic of PDAC. A comprehensive genomic profiling test detected KRAS and TP53 mutations, leading to the final diagnosis of PDAC (fT3N1aM0, stage IIB). The patient received adjuvant S-1 chemotherapy and remained recurrence-free for 15 months post-surgery. This case highlights the diagnostic challenges of differentiating intraductal pancreatic tumors and demonstrates the utility of integrating genetic testing with conventional diagnostic modalities for an accurate diagnosis and appropriate treatment selection.

摘要

我们在此报告一例发生于胰管内的胰腺导管腺癌（PDAC），该病例最初被诊断为导管内管状乳头状肿瘤（ITPN）。一名76岁男性患者出现体重减轻和主胰管扩张。影像学检查显示胰头主胰管内有一个30毫米的低血运肿瘤。内镜检查及活检显示高级别非典型上皮细胞，免疫染色模式提示为ITPN。在机器人辅助胰十二指肠切除术后，术后病理显示出相互矛盾的特征：ITPN典型的心形/筛状浸润以及PDAC特征性的非小叶性替代伴散在浸润。全面基因组分析检测发现KRAS和TP53突变，最终诊断为PDAC（fT3N1aM0，IIB期）。患者接受了辅助性S-1化疗，术后15个月无复发。该病例突出了区分胰腺导管内肿瘤的诊断挑战，并证明了将基因检测与传统诊断方法相结合对于准确诊断和合理选择治疗方法的实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/13b428b7546b/12328_2025_2098_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/3e32caacc7d5/12328_2025_2098_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/1db2b04cbbce/12328_2025_2098_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/21530566627c/12328_2025_2098_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/b80af85d4df8/12328_2025_2098_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/aaa8bcc087f7/12328_2025_2098_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/13b428b7546b/12328_2025_2098_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/3e32caacc7d5/12328_2025_2098_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/1db2b04cbbce/12328_2025_2098_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/21530566627c/12328_2025_2098_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/b80af85d4df8/12328_2025_2098_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/aaa8bcc087f7/12328_2025_2098_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20e1/11922994/13b428b7546b/12328_2025_2098_Fig6_HTML.jpg

相似文献

1
A case of pancreatic ductal adenocarcinoma growing within the pancreatic duct mimicking an intraductal tubulopapillary neoplasm.一例生长于胰管内的胰腺导管腺癌，酷似导管内管状乳头状肿瘤。
Clin J Gastroenterol. 2025 Apr;18(2):376-382. doi: 10.1007/s12328-025-02098-y. Epub 2025 Feb 5.
2
[A rare case of intraductal tumor of the pancreas in which an intraductal tubulopapillary neoplasm was mixed with a widely spreading gastric-type intraductal papillary-mucinous neoplasm].[一例罕见的胰腺导管内肿瘤，其中导管内管状乳头状肿瘤与广泛播散的胃型导管内乳头状黏液性肿瘤混合存在]
Nihon Shokakibyo Gakkai Zasshi. 2024;121(5):415-424. doi: 10.11405/nisshoshi.121.415.
3
Intraductal tubulopapillary neoplasm (ITPN) of the pancreas associated with an invasive component: a case report with review of the literature.胰腺导管内管状乳头状肿瘤（ITPN）伴侵袭性成分：病例报告并文献复习。
World J Surg Oncol. 2017 Nov 16;15(1):203. doi: 10.1186/s12957-017-1267-4.
4
A case of MUC5AC-positive intraductal neoplasm of the pancreas classified as an intraductal tubulopapillary neoplasm?一例MUC5AC阳性的胰腺导管内肿瘤，可归类为导管内管状乳头状肿瘤吗？
Pathol Res Pract. 2015 Dec;211(12):1034-9. doi: 10.1016/j.prp.2015.10.009. Epub 2015 Oct 30.
5
A case of intraductal tubulopapillary neoplasm of the pancreas in a branch duct: a rare case report and literature review.一例胰腺分支导管内管状乳头状瘤：罕见病例报告及文献复习
BMC Gastroenterol. 2021 Apr 13;21(1):162. doi: 10.1186/s12876-021-01744-2.
6
Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumors.胰腺导管内管状乳头状肿瘤（ITPN）：胰腺肿瘤中的一个独特实体。
Histopathology. 2022 Sep;81(3):297-309. doi: 10.1111/his.14698. Epub 2022 May 27.
7
Concurrent presentation of an intraductal tubulopapillary neoplasm and intraductal papillary mucinous neoplasm in the branch duct of the pancreas, with a superior mesenteric artery aneurysm: a case report.胰腺分支胆管内同时存在管状乳头型肿瘤和导管内乳头状黏液性肿瘤，伴肠系膜上动脉动脉瘤：一例报告。
World J Surg Oncol. 2018 Apr 24;16(1):83. doi: 10.1186/s12957-018-1391-9.
8
Imaging findings of intraductal tubulopapillary neoplasm (ITPN) of the pancreas: Two case reports and literature review.胰腺导管内乳头状肿瘤（ITPN）的影像学表现：两例病例报告及文献复习
Medicine (Baltimore). 2019 Feb;98(6):e14426. doi: 10.1097/MD.0000000000014426.
9
The discrete nature and distinguishing molecular features of pancreatic intraductal tubulopapillary neoplasms and intraductal papillary mucinous neoplasms of the gastric type, pyloric gland variant.胰腺导管内管状乳头肿瘤和胃型、幽门腺型的胰腺导管内乳头状黏液性肿瘤的离散性质和独特分子特征。
J Pathol. 2013 Nov;231(3):335-41. doi: 10.1002/path.4242.
10
An extremely rare case who underwent total remnant pancreatectomy due to recurrent pancreatic metastasis of intraductal tubulopapillary neoplasm.一名极为罕见的病例，因导管内管状乳头状肿瘤复发性胰腺转移而接受了全胰切除术。
Clin J Gastroenterol. 2019 Apr;12(2):153-159. doi: 10.1007/s12328-018-0913-x. Epub 2018 Oct 4.

本文引用的文献

1
Clinical Relevance of Cancerization of Ducts in Resected Pancreatic Ductal Adenocarcinoma.切除的胰腺导管腺癌中导管癌变的临床相关性。
Pancreas. 2024 Jul 1;53(6):e528-e536. doi: 10.1097/MPA.0000000000002326.
2
Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma.胰腺导管内管状乳头状肿瘤的影像学特征及其与常规胰腺导管腺癌的鉴别诊断。
Sci Rep. 2022 Sep 16;12(1):15557. doi: 10.1038/s41598-022-19517-6.
3
Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumors.
胰腺导管内管状乳头状肿瘤（ITPN）：胰腺肿瘤中的一个独特实体。
Histopathology. 2022 Sep;81(3):297-309. doi: 10.1111/his.14698. Epub 2022 May 27.
4
[Intraductal neoplasms of the pancreas].[胰腺导管内肿瘤]
Pathologe. 2021 Sep;42(5):472-483. doi: 10.1007/s00292-021-00966-1. Epub 2021 Aug 17.
5
Intraductal pancreatic cancer is less responsive than cancer in the stroma to neoadjuvant chemotherapy.导管内胰腺癌对新辅助化疗的反应不如基质癌敏感。
Mod Pathol. 2020 Oct;33(10):2026-2034. doi: 10.1038/s41379-020-0572-6. Epub 2020 May 26.
6
The 2019 WHO classification of tumours of the digestive system.2019年世界卫生组织消化系统肿瘤分类。
Histopathology. 2020 Jan;76(2):182-188. doi: 10.1111/his.13975. Epub 2019 Nov 13.
7
Randomized phase II/III trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02/JSAP05).吉西他滨与S-1新辅助化疗对比直接手术治疗可切除胰腺癌的随机II/III期试验（Prep-02/JSAP05）
Jpn J Clin Oncol. 2019 Feb 1;49(2):190-194. doi: 10.1093/jjco/hyy190.
8
Intrapancreatic recurrence of intraductal tubulopapillary neoplasm (ITPN) 16 years after the initial surgery for noninvasive ITPN: a case report.非侵袭性导管内乳头状肿瘤（ITPN）初次手术后16年胰腺内复发：1例报告
Surg Case Rep. 2018 Aug 16;4(1):96. doi: 10.1186/s40792-018-0497-1.
9
Integrated Genomic Characterization of Pancreatic Ductal Adenocarcinoma.胰腺导管腺癌的综合基因组特征分析
Cancer Cell. 2017 Aug 14;32(2):185-203.e13. doi: 10.1016/j.ccell.2017.07.007.
10
Pancreatic intraductal tubulopapillary neoplasm is genetically distinct from intraductal papillary mucinous neoplasm and ductal adenocarcinoma.胰腺导管内管状乳头状肿瘤在遗传学上有别于导管内乳头状黏液性肿瘤和导管腺癌。
Mod Pathol. 2017 Dec;30(12):1760-1772. doi: 10.1038/modpathol.2017.60. Epub 2017 Aug 4.