胰腺胰岛细胞瘤临床病理分析并文献复习

Clinicopathologic Analysis of Pancreas Islet Cell Tumor: a Literature Review

目的探讨胰腺胰岛细胞瘤的临床病理学特点及诊断要点。方法对2例胰腺胰岛细胞瘤进行临床资料、病理形态学及免疫组化观察,并结合文献对其诊断及鉴别诊断进行探讨。结果镜下可见细胞中等偏小,大小均匀一致,未见大核细胞,核居中,核仁明显。排列均为实性,呈片状或梁索状。肿瘤间质的血管丰富,局灶可见大量出血。2例神经内分泌标记Syn、Cg A表达均为阳性,1例AACT和AAT局灶表达阳性,另1例Insulin表达阳性,均符合胰腺胰岛细胞瘤的诊断。结论掌握胰腺胰岛细胞瘤的病理特点,提高对恶性胰岛细胞瘤的认识,对避免误诊是至关重要的。

Objective To explore the clinicopathologic characteristics and diagnostic criteria of pancreas islet cell tumor. Methods Clinical data,pathomorphology and immunohistochemical staining of 2 patient with pancreas islet cell tumor were observed,and its diagnosis and differential diagnosis combined with literature were also analyzed. Results Microscopic examination showed that tumor cells were uniform size from medium to small without large nucleus cells,and nucleus was in the center with prominent nucleoli. The permutation was solid,lamellar or trabecular. Tumor intercellular substance was seen with a large number of blood vessels,and massive bleeding was found in part of lesions. Neuroendocrine markers such as Syn and Cg A expressions were positive in 2 patients. One patient had positive expressions of AACT and AAT in part of lesions,and the other patient had Insulin positive expression,which supported the diagnosis of pancreas islet cell tumor. Conclusion It is essential to grasp the pathological characteristics of pancreas islet cell tumor and enhance awareness so as to avoid misdiagnosis.