胰腺微囊/网状型神经鞘瘤临床病理特征

Clinicopathologic features of microcystic /reticular schwannoma in pancreas

目的探讨微囊/网状型神经鞘瘤的临床病理特征及鉴别诊断。方法对1例发生在胰腺的微囊/网状型神经鞘瘤进行HE和免疫组化染色检测,观察其形态学及免疫表型特点,并复习相关文献。结果患者中年男性,体检发现胰腺占位。肿块边界清楚,表面部分有包膜;切面实性,局灶黏液状。镜下呈网状、微囊状、假腺样或筛状结构,细胞异型性小,间质明显黏液变性和纤维化;灶性区域肿瘤累及包膜,但未见浸润周围正常组织。免疫组化:S-100、SOX10和CD56(+),CKpan和EMA(-)。结论微囊/网状型神经鞘瘤是一种与普通神经鞘瘤组织形态截然不同的肿瘤,应与胃肠道间叶性肿瘤和上皮性恶性肿瘤鉴别。

Objective To define the clinicopathologic features and differential diagnosis of pancreatic microcystic/reticular schwannoma.Methods A case of microcystic/reticular schwannoma occurring in pancreas was described,and the pathologic features and immunophenotypic profile were studied.Results The patient was a 41-year-old male and presented with a lump in pancreas on radiologic check up.Grossly,the lump was well-circumscribed but non-encapsulated.Histologically,it was arranged in a reticular,microcystic,adenoid or cribriform pattern with mild atypia cells and a myxoid matrix.Immunohistochemical study showed that the tumor cells were positive for S-100,SOX10 and CD56,and negative for CKpan and EMA.Conclusions Microcystic/reticular schwannonm is a novel variant of schwannoma,arising mainly in internal viscera.Awareness of this entity is helpful in distinction from other tumors.