胰腺实性假乳头状肿瘤19例临床病理分析  

Clinicopathological Analysis of Solid-Pseudopapillary Neoplasms of Pancreas of 19 Cases

作　　者：马妍 王玉红 杨红丽 黄山[1] MA Yan;WANG Yu-hong;YANG Hong-li;HUANG Shan(Department of Pathology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院病理科,江苏苏州215006

出　　处：《中国血液流变学杂志》2023年第3期419-423,F0002,共6页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(81902969)。

摘　　要：目的探讨胰腺实性假乳头状肿瘤(solid-pseudopapillary neoplasm,SPN)的临床资料、影像学表现、病理特征、免疫表型及鉴别诊断。方法收集2010年1月至今苏州大学附属第一医院收治的胰腺SPN患者19例的临床病理资料及随访结果,并复习相关资料。结果19例SPN患者影像学上肿物边界清楚,密度低于胰腺实质。其中男性3例,女性16例,年龄20~62岁(中位年龄31岁),临床表现主要为不同程度的腹胀、腹痛。肿块分布:3例胰头部,3例胰颈部,5例胰尾部,8例胰体尾部。肿块直径1 cm~大小15 cm×12 cm×8 cm,包膜多完整,肿块切面10例为实性,6例为囊实性,3例为囊性。Vimentin阳性17例,β-catenin、CD56均为阳性,PR阳性16例,CD10阳性17例,Syn阳性15例,CgA阳性1例,NSE阳性18例。所有病例均经手术切除病灶,术后均未出现转移或复发。结论SPN作为一种低度恶性的胰腺肿瘤,好发于年轻女性,手术切除预后良好,需与胰腺神经内分泌肿瘤、胰腺腺泡细胞癌相鉴别,避免误诊、误治。Objective To investigate the clinical data,imaging features,pathological features,immunophenotypes and differential diagnosis of solid-pseudopapillary neoplasms(SPN)of the pancreas.Methods Clinicopathological data and follow-up results of 19 patients with pancreatic SPN admitted to First Affiliated Hospital of Soochow University from January 2010 to present were collected,and the relevant data were reviewed.Results The mass of 19 patients with SPN had clear boundary and lower density than pancreatic parenchyma on imaging.Among them,there were 3 males and 16 females,aged 20-62 years(median age 31 years).The main clinical manifestations were abdominal distension and abdominal pain of varying degrees.Mass distribution:3 cases at the head of pancreas,3 cases at the neck of pancreas,5 cases at the tail of pancreas,8 cases at the tail of pancreas body.The tumor was 1 cm in diameter to 15 cm×12 cm×8 cm in size,and the capsule was mostly intact.The tumor section was solid in 10 cases,cystic solid in 6 cases,and cystic in 3 cases.Immunohistochemically,the tumors were positive for vimentin(17/19),β-catenin(19/19),CD56(19/19),PR(16/19),CD10(17/19),Syn(15/19),CgA(1/19),NSE(18/19).All cases underwent surgical resection of the lesion,and no postoperative metastasis or recurrence occurred.Conclusion SPN,as a low-grade malignant pancreatic tumor,tends to occur in young women and has a good prognosis after surgical resection.It should be differentiated from neuroendocrine tumor and acinar cell carcinoma to avoid misdiagnosis and mistreatment.

关 键 词：胰腺实性假乳头状瘤 临床病理特征 免疫表型 鉴别诊断 

分 类 号：R735.9[医药卫生—肿瘤]