Fukushima N, Mukai K, Kanai Y, Hasebe T, Shimada K, Ozaki H, Kinoshita T, Kosuge T
Pathology Division, National Cancer Center Research Institute, East, Kashiwa, Chiba, Japan.
Hum Pathol. 1997 Sep;28(9):1010-7. doi: 10.1016/s0046-8177(97)90053-8.
Clinicopathological features of 28 patients with intraductal papillary tumor (IDPT) and 10 patients with mucinous cystic tumor (MCT) of the pancreas were studied. Both IDPT and MCT showed papillary projections of the epithelium with abundant mucus secretion in the ectatic ducts or cystic spaces. The patients with IDPT comprised 19 men and 9 women with a mean age of 64.9 years. Three fourths of the IDPTs were located in the pancreatic head, and the mean tumor size was 3.5 cm. Local recurrence was observed in one patient, but none died of IDPT. In contrast, all patients with MCT were women, with a mean age of 49.4 years. None of the MCTs arose in the head, and the mean tumor size was 7.1 cm. One patient died of MCT, but all of the others survived without recurrence. Eight IDPTs and three MCTs showed invasion into the surrounding pancreatic tissue. Muconodular infiltration was mainly observed in five IDPTs and one MCTs and tubular infiltration in three IDPTs and two MCTs. A characteristic histological finding associated with the muconodular infiltration in IDPT was subepithelial "mucin droplets" that appeared to represent a change in polarity of mucus secretion. The formation of such subepithelial "mucin droplets" may be the initial step of muconodular infiltration in IDPT. Muconodular infiltration in IDPT appears different morphologically and biologically from the mucinous carcinoma subtype of conventional invasive ductal carcinoma.
对28例胰腺导管内乳头状肿瘤（IDPT）患者和10例胰腺黏液性囊性肿瘤（MCT）患者的临床病理特征进行了研究。IDPT和MCT在扩张的导管或囊腔内均显示上皮的乳头状突起，伴有大量黏液分泌。IDPT患者包括19名男性和9名女性，平均年龄64.9岁。四分之三的IDPT位于胰头，平均肿瘤大小为3.5 cm。1例患者出现局部复发，但无患者死于IDPT。相比之下，所有MCT患者均为女性，平均年龄49.4岁。所有MCT均未发生于胰头，平均肿瘤大小为7.1 cm。1例患者死于MCT，但其他所有患者均存活且无复发。8例IDPT和3例MCT显示侵犯周围胰腺组织。黏液结节状浸润主要见于5例IDPT和1例MCT，管状浸润见于3例IDPT和2例MCT。IDPT中与黏液结节状浸润相关的一个特征性组织学表现是上皮下“黏液滴”，似乎代表黏液分泌极性的改变。这种上皮下“黏液滴”的形成可能是IDPT中黏液结节状浸润的起始步骤。IDPT中的黏液结节状浸润在形态学和生物学上似乎与传统浸润性导管癌的黏液癌亚型不同。
