胰腺实性假乳头状瘤21例临床病理分析

Clinicopathological analysis and immunophenotype of solid-pseudopapillary neoplasm of the pancreas

目的探讨胰腺实性假乳头状瘤(SPNP)的临床病理特征及免疫表型特征。方法对21例SPNP进行组织病理学检查及免疫组化分析。结果组织病理学检查结果主要表现为肿瘤由乳头区和囊实区混合组成,形态一致的肿瘤细胞围绕纤维血管轴心形成特征性的假乳头状结构。免疫组化检查结果:抗胰糜蛋白酶(AACT)、波形蛋白(Vimentin)、神经元特异性烯醇化酶(NSE)、半乳糖凝集素3(Galectin3)、孕激素受体(PR)、共同型急性淋巴细胞白血病抗原(CD10)、神经细胞黏附分子(NCAM/CD56)、周期素D1(CyclinD1)阳性表达,细胞角蛋白(AE1/AE3)、上皮膜抗原(EMA)、嗜铬素A(CgA)阴性表达,Ki-67阳性指数极低。结论 SPNP是好发于年轻女性的低度恶性潜能的少见肿瘤,其诊断和鉴别诊断主要依靠组织病理学和免疫组化检查。手术切除是SPNP首选治疗方法。

Objective To study the clinicopathologic features and immunophenotype of solid-pseudopapillary neoplasm of the pancreas（SPNP）.Methods Twenty-one cases of SPNP were studied by using clinicopathologic data,light microscope observation and immunohistochemistry.Results The tumor were composed of papillary and microcystic solid structures,tumor cells size morphology more consistent.pseudopapillary with fibrovascular core was remarkable.Immunohistochemically,the tumors were positive for AACT,Vimentin,NSE,Galectin3,PR,CD10,CD56 and CyclinD1,the tumors were negative for AE1/AE3、EMA and CgA,positive index of Ki-67 was very low.Conclusion SPNP is a rare tumor of low-grade malignancy occurred in young females.Pathohistology and immunohistochemistry is very important for the diagnosis and differential diagnosis of SPNP.Surgical resection is the primary therapy for these patients.