胰腺囊性-实性肿瘤的临床病理诊断

Clinical pathologic diagnosis of solid cystic tumor of pancreas

目的：探讨胰腺囊性－ 实性肿瘤临床病理、免疫组化特点、组织发生及生物学行为。方法：对２ 例胰腺囊性－ 实性肿瘤进行光镜观察及免疫组化染色。结果：２ 例均为年轻女性（２１ 岁和３５ 岁）。肿物为半囊半实性。ＨＥ染色片中瘤细胞大小形态较一致，核圆形或卵圆形，核异型性不明显，核分裂象罕见。肿瘤细胞围绕纤维血管复层排列形成假乳头突起为其特征。免疫组化染色显示α１ＡＴ、ＥＲ和ＰＲ均阳性，ＣＥＡ、Ｓ１００ 、ＮＳＥ均阴性。随访：１ 例带瘤生存２ 年后死亡，１ 例术后９ 个月健在。结论：胰腺囊性实性肿瘤可能来源于腺泡细胞，为性激素依赖性肿瘤，具有侵袭性行为，是一种低度恶性肿瘤。

Purpose To explore the clinicopathologic and the immunohistochemical features, the histogenesis and the biological behaviour of solid cystic tumor(SCT) of the pancreas. Methods Two cases of SCT were observed by light microscope and using immnohistochemical staining. Results Two cases of SCT occurring in 21 and 35 year old women. Both tumors were all cystic and solid masses. They were grossly well circumscribed by a fibrous capsule. Both were microscopic infiltration of the surrounding pancreatic parenchyma by tumor. In HE staining, the tumor cells were fairly bland, with pale eosinophilic cytoplasma and regular round to oval nuclei. Mitoses were extremaly rare. The tumor cells ranged arround fibrous vascular and formed a pseudopapillar appearance. Immunohistochemical staining showed that the tumor cells were α 1 AT(+), ER(+), PR(+), CEA(-),S 100(-),NSE(-). One case died after two years survival bearing tumor. One case had survived for nine nonths postoperatively. Conclusion The SCT may come from acinar and is a sex hormone responsive tumor. It is a lower grade malignant tumor which has invading ability.