胰腺浆液性微囊性腺瘤2例报道

Serous microcystic adenoma of pancreas: a report of two cases

目的探讨胰腺浆液性微囊性腺瘤（SMA）临床病理特征及诊断与鉴别诊断。方法分析2例SMA的临床资料、病理特点及免疫表型,并复习相关文献。结果 2例均为女性,症状为腹胀和腹痛。肿块边界清,微囊状。镜下示大小不一的囊腔,内衬单层扁平或立方上皮,胞质透明,间质见粗细不等的纤维分隔。2例均伴双肾多发囊肿,1例伴肝血管瘤和胃癌。上皮细胞CK7、CK19、CK8/18、EMA、Muc1及NSE均阳性,CEA、Cg A和Syn均阴性。随访12~23个月未见复发,患者及亲属未见视网膜或中枢神经系统发生血管母细胞瘤。结论 SMA是胰腺少见的良性肿瘤,结合影像、病理及免疫表型可明确诊断。SMA可能不是单独的疾病,常伴发多脏器病变,提示临床重视对SMA患者其他脏器进行检查。

Objective To investigate the clinicopathological features,diagnosis,and differential diagnosis of serous microcystic adenoma（SMA） of pancreas.Methods The clinicopathological and immu no histo chemical features of 2 cases of SMA of pancreas were analysed and relevant literatures were reviewed.Results Both 2patients were female.The clinical symptoms were abdominal distension and pain.Neoplasms were well demarcated frequently with multicystic appearance on section.Microscopically,the tumors were composed of numerous microcysts lined by a single layer of cuboidal cells.The stroma of tumor was found to contain thick or thin fibrous tissue.Both cases were accompanied with polycyst of both kidneys,and one case was also accompanied with hemangioblastoma of liver and gastric adenocarcinoma.C K7,CK19,CK8/18,EM A,Mucl,and NSE were positive and CEA,CgA,and Syn were negative.No recurrence was found during the follow-up of 12-23 months.Hemangioblastoma of retina or central nervous system was not occurred in patients and their relatives.Conclusion SMA is a rare benign tumor of pancreas.A definite diagnosis can be made according to the radiological,morphological,and immunohistochemical features.SMA may not be a single disease and is often accompanied with multiple organ lesions.This suggests that the clinician should pay attention to examining other organs of SMA patients.