胰腺实性-假乳头状瘤影像与病理诊断分析  

Imaging and Pathologic Diagnosis of Solid Pseudo-papilloma of Pancreas

作　　者：缪飞[1] 展颖[1] 王晓颖[2] 丁蓓[1] 汪登斌[1] 丁晓毅[1] 张蓓[1] 

机构地区：[1]上海第二医科大学瑞金医院放射科,200025 [2]上海第二医科大学瑞金医院病理科,200025

出　　处：《临床放射学杂志》2004年第7期589-592,共4页Journal of Clinical Radiology

摘　　要：目的　探讨胰腺实性 假乳头状瘤的影像及病理学的诊断要点。资料与方法　回顾分析 11例经手术切除、病理学和免疫组织化学证实的胰腺实性 假乳头状瘤患者的临床资料 ,以比较其影像和病理学特点。结果　 (1)本病多发于 30岁以下女性 ,临床主要表现为腹痛。 (2 )CT、MRI表现为肿瘤内有实性和囊性结构 ,可分为 3型 ;特征性表现为“浮云征”。 (3)肿瘤大部分位于胰腺 ,多有完整包膜 ,不伴有胆总管扩张。 (4 )病理学特点为肿瘤实性部分由实性区、假乳头区及两者过渡区以不同比例混合而成。囊性区由坏死、液化、陈旧性出血组成。 (5 )肿瘤的囊实性结构是形成“浮云征”的病理基础。结论　胰腺实性 假乳头状瘤有相对特征性的影像和病理学表现 。Objective To discuss the key points in the imaging and pathologic diagnosis of solid pseudo-papilloma of pancreas.Materials and Methods Both clinical data and imaging findings in 11 cases with pathologically- and immunohistochemically-proved solid pseudo-papilloma of pancreas were retrospectively analyzed. Imaging features were compared with pathological results. Results (1) The disease mainly occurred in women under 30 years, with abdominal pain as the chief complaint. (2) On CT and MRI, the lesion presented as a mss containing both solid and cystic components. The disease could be divided into three types. The “floating cloud” sign was characteristic. (3) The tumor was mainly located in the pancreas with complete capsule, no common bile duct dilatation was accompanied. (4) Pathologically, the solid part of the tumor was made up of solid components, pseudo-papillary region and transition zone, while the cystic part was made up of necrosis, liquefaction and remote hemorrhage. (5) The solid and cystic structure was the pathologic basis for the formation of “floating cloud” sign.Conclusion The solid pseudo-papilloma of pancreas has certain characteristic imaging and pathologic features. The patient carries an excellent prognosis after surgical excision of the tumor.

关 键 词：胰腺实性-假乳头状瘤 影像 病理诊断 CT MRI 

分 类 号：R735.9[医药卫生—肿瘤]