Buetow P C, Parrino T V, Buck J L, Pantongrag-Brown L, Ros P R, Dachman A H, Cruess D F
Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
AJR Am J Roentgenol. 1995 Nov;165(5):1175-9. doi: 10.2214/ajr.165.5.7572498.
The purpose of our study was to correlate the imaging and pathologic features of islet cell tumors with regard to tumor size, necrosis and cysts, calcification, malignant behavior, and functional status.
We retrospectively reviewed the clinical, pathologic, and imaging features of all 133 cases of pathologically proved islet cell tumors of the pancreas seen at the Armed Forces Institute of Pathology. Clinical data, including the patients' symptoms and serologic characteristics, were used to distinguish hyperfunctioning tumors (those causing symptoms related to elevated serum polypeptide levels) from nonhyperfunctioning tumors; hyperfunctioning tumors were divided further into insulin-producing and non-insulin-producing types. All patients had at least one cross-sectional imaging study, including CT (n = 118), sonography (n = 42), or MR imaging (n = 22). Clinical, pathologic, and imaging features were evaluated and correlated with tumor size, necrosis and cysts, calcification, local invasion, vascular invasion, metastases, and functional status.
Islet cell tumors with areas of necrosis or cystic change found pathologically and on imaging studies (56/133) were larger (8.4 cm in mean transverse diameter) than homogeneous solid lesions (2.9 cm in mean transverse diameter) and were predominantly non-insulin producing (48/56) and nonhyperfunctioning (36/56). Of the 43 insulinomas, 35 were small (2.2 cm in mean transverse diameter), solid, and homogeneous. Larger size also was associated with calcification and malignant behavior, including local invasion, vascular invasion, and distant metastases.
Our findings show that cystic and necrotic islet cell tumors are usually non-insulin-producing and nonhyperfunctioning neoplasms and larger than the typically solid and small insulinomas. Calcification, local invasion, vascular invasion, and metastatic disease are more commonly seen with larger neoplasms.
我们研究的目的是将胰岛细胞瘤的影像学和病理学特征与肿瘤大小、坏死与囊肿、钙化、恶性行为及功能状态进行关联分析。
我们回顾性分析了美国武装部队病理研究所133例经病理证实的胰腺胰岛细胞瘤的临床、病理及影像学特征。临床数据，包括患者症状和血清学特征，用于区分功能亢进性肿瘤（那些导致与血清多肽水平升高相关症状的肿瘤）和非功能亢进性肿瘤；功能亢进性肿瘤进一步分为胰岛素分泌型和非胰岛素分泌型。所有患者至少进行了一项横断面影像学检查，包括CT（n = 118）、超声（n = 42）或磁共振成像（n = 22）。对临床、病理及影像学特征进行评估，并与肿瘤大小、坏死与囊肿、钙化、局部侵犯、血管侵犯、转移及功能状态进行关联分析。
病理及影像学检查发现有坏死或囊性变区域的胰岛细胞瘤（56/133）比均匀实性病变（平均横径2.9 cm）更大（平均横径8.4 cm），且主要为非胰岛素分泌型（48/56）和非功能亢进性（36/56）。43例胰岛素瘤中，35例体积较小（平均横径2.2 cm），为实性且均匀。较大的肿瘤还与钙化及恶性行为相关，包括局部侵犯、血管侵犯和远处转移。
我们的研究结果表明，囊性和坏死性胰岛细胞瘤通常为非胰岛素分泌型和非功能亢进性肿瘤，且比典型的实性小胰岛素瘤更大。钙化、局部侵犯、血管侵犯和转移性疾病在较大肿瘤中更常见。
