胰腺囊性病变17例临床病理分析  

Pancreatic cystic lesions:a clinicopathological analysis of 17 cases

作　　者：王云帆[1] 缪琦[1] 胡阿锦 王跃[1] 张雨 WANG Yun-fan;MIAO Qi;HU A-jin;WANG Yue;ZHANG Yu(Department of Pathology,Peking Universisity Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院病理科,北京100144

出　　处：《诊断病理学杂志》2020年第5期311-317,共7页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胰腺囊性病变的临床病理特点、诊断及鉴别诊断。方法对17例胰腺囊性病变的临床资料、组织学特点及免疫组化进行回顾性分析,并结合相关文献讨论。结果 17例患者中男性5例,女性12例,平均年龄55岁。多数为无症状偶然发现,以胰体尾部居多。所有患者均行手术治疗,其中导管内乳头状黏液性肿瘤5例(29. 4%)(伴相关浸润性癌1例,伴高级别异型增生1例,伴低级别异型增生3例),实性-假乳头瘤4例(23. 5%),黏液性囊性肿瘤伴轻度异型增生2例(11. 8%),浆液性囊腺瘤2例(11. 8%),假性囊肿2例(11. 8%),伴囊性变的导管腺癌及淋巴上皮囊肿各1例(5. 9%)。结论胰腺囊性病变多数为良性,掌握临床病理特征有助于准确的病理诊断,对于判断预后及推动胰腺囊性肿瘤的规范化治疗具有重要意义。Objective To analyze the clinicopathological features and differential diagnosis of pancreatic cystic lesions.Methods Seventeen cases of pancreatic cystic lesions were analyzed on clinical data and histology,pathologic features and immunohistochemistry,followed by discussion through review of the relevant literature.Results There were five males and twelve females,and the mean age of patients was 55 years.They were mostly asymptomatic or nonspecific symptoms,and more commonly occured in the pancreatic body or tail.All patients underwent surgery;there were 5 cases of pancreatic intraductal papillary mucinous neoplasma(29.4%)(1 case associated with invasive carcinoma,1 case with high-grade dysplasia,and 3 cases with low-grade dysplasia),4 cases of solid pseudopapillary neoplasm(23.5%),2 cases of mucinous cystic neoplasm with low-grade dysplasia(11.8%),2 cases of serous cystadenoma(11.8%),and 1 case of pancreatic ductal adenocarcinoma with cystic features and lymphoepithelial cysts(5.9%).Conclusions The majority of pancreatic cystic lesions are benign and the diagnosis depends on morphological observation of pathology.Accurate pathological diagnosis plays an important role in patients’treatment and evaluation of prognosis.

关 键 词：胰腺 囊性病变 囊性肿瘤 鉴别诊断 

分 类 号：R735.9[医药卫生—肿瘤]