胰腺实性假乳头状肿瘤临床病理分析  

Solid pseudopapillary tumor of pancreas: a clinicopathological analysis

作　　者：李里香[1] 黄传生 张文昌[1] 雷瑛[1] 

机构地区：[1]江西医学院第二附属医院病理科,南昌330006 [2]江西肿瘤医院病理科,南昌330029

出　　处：《临床与实验病理学杂志》2005年第5期588-590,共3页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨胰腺实性假乳头状瘤(solid-pseudo-pap illary tumor of pancreas,SPT)的临床病理学特点及其生物学行为。方法对6例SPT临床及病理资料进行回顾性复习,光镜观察其形态学特征,并采用免疫组化S-P法检测肿瘤细胞α-AT等9种抗体的表达,并对其中1例做AB/PAS染色。结果6例SPT中5例为女性、1例为男性,平均年龄34岁,瘤体平均直径9.3cm;光镜下瘤细胞圆形,大小较一致,无明显异型性,排列成实性片状区和假乳头状结构,假乳头轴心黏液变性,囊性区常见出血、坏死;其中1例除上述特征外还出现了大量的印戒细胞样瘤细胞,这些瘤细胞AB/PAS染色阴性,CEA阴性,S-100蛋白阴性,随访至今已4年余,无复发及转移。2例浸润包膜及周围胰腺组织;6例中3例有随访的均健在且无复发及转移。免疫组化检测:6例V im阳性(6/6),4例α-AT阳性(4/6),3例Syn阳性(3/6),1例CK弱阳性(1/6)、PR阳性(1/6),ER阴性(0/6),EMA阴性(0/6),CEA阴性(0/6),S-100蛋白阴性(0/6)。结论SPT好发于年轻女性;组织形态学特征为瘤细胞大小一致,排列成实性片状区与独特的假乳头状结构,偶见瘤细胞呈印戒细胞样,间质可黏液变性;该肿瘤生物学行为交界性或恶性潜能未定的肿瘤,即使出现包膜及周围胰腺浸润,预后亦较好。Purpose To study the clinicopathologic characteristics and biologic behavior of solid pseudopapillary tumor （SPT） of pancreas. Methods The clinical and pathologic data were retrospectively reviewed in six cases of SPT. The expression of α-AT, Vim, Syn, EMA, CK, ER, PR, CEA and S-100 protein were detected By using S-P immunohistochemical methods. Meanwhile, AB/ PAS staining was performed in one case by using histochemical method. Results Five cases were female, with average age of 34 years, and one male patient was 45 years old. The average diameter of the tumor was 9. 3 cm. Histologically, the tumor cells were round, consistency in size, no atypia, arranged in the solid sheet and pseudo-papillary forms. In the center of pseudo-papillary area, there was mucus degeneration. The cystic areas often had haemorrhage and necrosis ; besides all of the above characteristics, one case showed lots of signet-ring cells with AB/PAS, CEA and S-100 protein negative. It was followed up for more than four years. No local recurrency and metastasis was found. In two cases the tumor infiltrated the capsula and pancreatic tissue. Three of the six followed up were still alive without recurrency and metastasis. Four cases α-AT positive （4/6）, six Vim positive （6/6）, three Syn positive （3/ 6）, one PR positive （ 1/6）, one CK weak positive （ 1/6）, EMA, ER, CEA and S-100 protein were all negative. Conclusions SPT is commonly seen in young female. Histological characteristics of the tumor cells are consistent in size, arrange in the form of solid sheet and pseudo-papillae, occasionally the signet-ring cells and mucus degeneration in interstitium can also be observed. Its biologic behavior is borderline or malignant potential undertermined. The prognosis is well even if the capsule and pancreatic tissue beside the tumor are invaded.

关 键 词：胰腺肿瘤 实性假乳头状肿瘤 免疫组织化学 

分 类 号：R735.9[医药卫生—肿瘤] R730.26[医药卫生—临床医学]