胰腺黏液性囊性肿瘤临床病理分析

Mucinous cystic neoplasms of the pancreas: a clinicopathologic study of 6 cases

目的 :探讨胰腺黏液性囊性肿瘤 (MCN)的临床病理学特点。方法 :6例MCN均行B超或CT检查。除 1例外 ,均作了手术切除治疗。对 6例MCN作常规HE及免疫组织化学染色观察。结果 :6例MCN中 ,女性 4例 ,男性 2例 ,平均年龄 4 7岁 ,均位于胰腺体尾部。黏液性囊腺瘤 (MCA) 3例 ,囊壁内衬高柱状黏液上皮 ,上皮周围可见卵巢样间质组织 ;黏液性囊腺癌(MCC) 3例 ,黏液上皮有不典型增生 ,均有囊壁或胰腺组织的浸润 ,1例上皮周围可见卵巢样间质。CEA和CK7在上皮中均阳性 ,c erbB 2均阴性 ,间质SMA均阳性。结论 :胰腺MCN是好发于中年女性的少见肿瘤 ,绝大多数发生于胰腺体尾部。MCA内衬高柱状上皮 ,上皮外由卵巢样间质包绕 ;MCC上皮细胞有不典型增生 ,浸润性生长。MCN手术切除率高。

Purpose To probe into the clinicopathologic features of mucinous cystic neoplasms(MCN)of the pancreas. Methods Six cases of MCNs were examined with B ultrasonics and CT, and resected besides one case. All cases were investigated by hematoxylin and eosin and immunohistochemistry. Results There were 4 women and 2 men in this study with a mean age of 47 years. All tumors were located in the body tail or tail of the pancreas. Three patients had mucinous cystadenomas(MCA), containing the tall columnar epithelial cells, supported by ovarian like stroma. Other three patients had mucinous cystadenocarcinomas(MCC)with epithelial atypia, only one case contained ovarian like stroma, and showed the cystic wall or pancreatic invasion of tumor cells. CEA and CK7 were positive for all cases, but c erbB 2 negative. SMA were all positive in the stroma. Conclusions Mucinous cystic neoplasms of the pancreas are uncommon tumors preferential middle aged women, and were frequently located in the body tail and tail of the pancreas. MCA contain tall columnar epithelia, supporting by ovarian like stroma. MCC show epithelial atypia and invasive growth of tumor cells. The majority of MCNs may be resected.