胰腺实性假乳头状瘤8例临床病理分析

Clinicopathological analysis of solid-pseudopapillary tumor of the pancreas

目的探讨胰腺实性假乳头状瘤(SPTP)的病理形态、免疫表型及鉴别诊断。方法对8例SPTP进行形态学观察,免疫组织化学标记及随访,并结合相关文献进行分析。结果 8例患者均为女性,平均33岁,入院时主要症状为:2例腹部疼痛,2例腹部包块合并黄疸,4例为健康体检时发现。肿瘤平均直径6 cm,组织学特征为相对单一的多边形细胞形成实性假乳头结构。免疫组织化学:Vim和a-ACT阳性率为100%,CKpan阳性率为25.0%,Syn和CgA阳性率为12.5%,PR阳性率为62.5%,EMA和ER阳性率为0。8例患者均行手术治疗,术后分别随访1～10年未发现死亡病例。结论 SPTP可能起源于胰腺胚胎的多潜能干细胞,诊断主要依据临床资料、特征性形态学改变和免疫组织化学染色,应注意鉴别诊断,预后较好。

Objective To study the clinicopathological,immunohistochemical features and differential diagnosis of solid-pseudopapillary tumor of the pancreas.Methods 8 cases solid-pseudopapillary tumor of the pancreas were studied by histological evaluation,immunohistochemical markers and follow-up information.The correlated literature was reviewed.Results The patients were all females and mean age was 33 years.The main symptoms were abdominal pain and mass.However,some patients were asymptoms.The mean diameter of these turmors was 6 cm.Histological features were solid and pseudopapillary region formed by relatively uniform polygonal cells.Immunohistochemistry showed positive expression of Vim（8/8）,a-ACT（8/8）,CK pan（2/8）,EMA（0/8）,Syn（1/8）,CgA（1/8）,PR（5/8）,ER（0/8）.All patients underwent operation and all cases were alive.Conclusion Solid-pseudopapillary tumor of the pancreas may derived form multipotent stem cells.Clinicopathological and immunohistochemical features paly an important role in the diagnosis and the different diagnosis.They have a relatively good prognosis.