Kim Y W, Park Y K, Lee S, Park J H, Lee S M, Hong S W, Lee J, Yang M H
Department of Pathology, College of Medicine, Kyung Hee University, Seoul, Korea.
J Korean Med Sci. 1997 Oct;12(5):469-72. doi: 10.3346/jkms.1997.12.5.469.
We report a case of pancreatic endocrine tumor admixed with a diffuse microcystic adenoma in a 67-year-old woman with a six months history of melena. Whipple's operation and near-total pancreatectomy were performed under the impression of a pancreatic cancer with duodenal invasion. The pancreas was enlarged and was entirely replaced by sponge-like tiny cysts, which were lined by a single layer of periodic acid Schiff positive cuboidal cells. Also encountered was a gray white solid area at the head portion which extended to the duodenum with an intraluminal polyp formation. The compact area was composed of solid and acinar structures of tumor cells, which showed a positive reaction for chromogranin A and neuron specific enolase, separated by delicate highly vascularized stroma. To the best of our knowledge, this is the first case report published with immunohistochemical studies to deal with a pancreatic endocrine tumor admixed with a diffuse microcystic adenoma.
我们报告一例67岁女性胰腺内分泌肿瘤合并弥漫性微囊性腺瘤，该患者有6个月的黑便病史。在胰腺癌伴十二指肠侵犯的诊断下进行了惠普尔手术和近全胰切除术。胰腺肿大，完全被海绵状小囊肿取代，囊肿内衬单层过碘酸希夫阳性立方形细胞。在头部还发现一个灰白色实性区域，延伸至十二指肠并形成腔内息肉。致密区域由肿瘤细胞的实性和腺泡结构组成，对嗜铬粒蛋白A和神经元特异性烯醇化酶呈阳性反应，其间为纤细的高度血管化间质。据我们所知，这是首例发表的伴有免疫组化研究的胰腺内分泌肿瘤合并弥漫性微囊性腺瘤的病例报告。
