胰腺导管内乳头状肿瘤病理诊断及鉴别诊断

Pathological diagnosis and differential diagnosis of intraductal papillary tumor of pancreas

目的探讨胰腺导管内乳头状肿瘤3种不同预后的组织学亚型的临床及病理特点,旨在提高病理医师诊断水平,更好的为临床服务。方法收集本院2019—2023年16例胰腺导管内乳头状肿瘤患者资料,并结合相关文献梳理诊断重点。结果3种组织学亚型为导管内乳头状黏液性肿瘤(IPMN)、导管内嗜酸细胞乳头状肿瘤(IOPN)和导管内管状乳头状肿瘤(ITPN)。三者临床特征相似,但预后差异较大,伴浸润时IPMN预后较差,ITPN其次,IOPN最好,组织学形态是其主要鉴别要点,免疫表型对其鉴别起辅助作用。结论病理组织学形态是区分胰腺导管内乳头状肿瘤组织学亚型的关键,免疫表型具有辅助作用。

Objective To study the clinical and pathological characteristics of three histological subtypes of intraductal papillary tumor of pancreas, in order to improve the diagnostic level of pathologists and provide better clinical service.Methods Data of 16 patients with intraductal papillary tumors of the pancreas diagnosed in our hospital from 2019 to 2023were collected. Combing important diagnosis points with relevant literature. Results Three histological subtypes were intraductal papillary mucinous neoplasm( IPMN), intraductal oncocytic papillary neoplasm( IOPN) and intraductal tubulopapillary neoplasm(ITPN). The clinical features of the three patients were similar, but the prognosis was different.The prognosis of IPMN with invasion was poorer than that of ITPN, IOPN was the best. Histological morphology was the main point of diagnosis, and immunophenotype plays an auxiliary role in the differential diagnosis. Conclusion Histopathology is the key to differentiate histological subtypes of intraductal papillary tumors of the pancreas, and immunophenotyping plays an auxiliary role.