以纤维化为主的胰腺癌超声图改变1例及临床跟踪报告

Ultrasonic Changes of Pancreatic Carcinoma with Fibrosis as Main Characteristic:A Case Report and Follow-up

胰腺癌起病隐匿,病情进展迅速,早期诊断困难,是预后最差的消化系统恶性肿瘤。本例胰腺癌病理主要以大量纤维化,偶见腺体,与其他文献报道的相关胰腺癌病理不同。引起周围软组织增生,病理提示可见切面灰白色、质硬、大量纤维成分增生,可疑病变胰腺内异形腺体成分少于周围软组织内异形腺体成分,免疫组化标记结果腺癌。高度怀疑为胰腺癌浸润引起周围软组织引起软组织大量纤维化增生,此为继发性腹膜后纤维化。在超声图像上多为胰腺肿大、回声不均、边界不清,而以大量纤维化回声为主、偶见腺体回声的病例实属少见。

Pancreatic cancer is a more common tumor of the digestive system.Due to the hidden nature of onset,rapid progress and a lack of early diagnosis,the prognosis of pancreatic cancer remains the worst.In this case,there is a large quantity of fibrotic tissue and fewer glands pathologically in the tumor tissues,which is different from other cases reported.The fibrosis of soft tissue near the site of the tumor was obvious.The section of the suspiciously diseased pancreas and nearby affected soft tissue was gray white and its consistency was hard,which mainly consisted of fibrous components histologically.There were more atypical glandular structures in the nearby affected soft tissues than in the suspiciously diseased pancreas.It was proven that these atypical glandular structures were adenocarcinoma components by the immunochemistry method.It was highly suspected that the infiltration of pancreatic carcinoma caused a large quantity of soft tissue fibrosis around the tumor,which was known as secondary retroperitoneal fibrosis.Pancreatic carcinomas are mostly pancreatic enlargement,uneven echo and unclear boundary on ultrasound images.On the contrary,a large quantity of fibrotic echoes and occasional glandular echoes are rare like this case.