Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and ...Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and 3 men) with pathologically proven solid pseudopapillary tumor of the pancreas were reviewed retrospectively. Two radiologists reviewed images for location, size and morphology, capsule and margin, density, enhancement pattern, calcification, dilatation of pancreatic duct, lymphadenopathy, vascular invasion, distant metastasis, and recurrence. Results On CT, the lesion presented as solitary, round (28.57%), oval (57.14%), or lobulated (14.28%) mass in pancreatic head (47.62%) with complete capsule (85.71%). Lesions smaller than 4cm in maximum diameter (47.62%) presented as predominantly solid mass whereas lesions greater than 4cm in diameter (52.28%) presented as heterogenous mass. On contrast administration, the viable solid portion of the tumor showed mild peripheral enhancement in arterial phase [enhancement degree<20Hounsfield unit (HU)] with progressive fill in during the portal and hepatic parenchyma phase (enhancement degree 20-40HU). Eighteen lesions (85.7%) had complete capsule. Two lesions (9.5%) had areas of high density (>60HU) on plain CT which due to hemorrhage. Dilatation of the pancreatic duct was rare (25%), and distant metastasis, regional lymphadenopathy, and tumor recurrence were absent. Nine patients (42.85%) had an abdominal CT follow-up for 24.55months (range, 2-60months) post-surgery without recurrence or distant metastasis. Conclusion Solid pseudopapillary tumor of the pancreas usually occurs in young females in the pancreatic head or tail. On CT, they manifest as moderate vascular mixed tumor, progressive enhancement of the viable solid portion, distinct tumor margin with capsule formation, and absence of regional lymphadenopathy.展开更多
目的探讨胰腺实性假乳头状瘤(solid-pseudo-pap illary tumor of pancreas,SPT)的临床病理学特点及其生物学行为。方法对6例SPT临床及病理资料进行回顾性复习,光镜观察其形态学特征,并采用免疫组化S-P法检测肿瘤细胞α-AT等9种抗体的表...目的探讨胰腺实性假乳头状瘤(solid-pseudo-pap illary tumor of pancreas,SPT)的临床病理学特点及其生物学行为。方法对6例SPT临床及病理资料进行回顾性复习,光镜观察其形态学特征,并采用免疫组化S-P法检测肿瘤细胞α-AT等9种抗体的表达,并对其中1例做AB/PAS染色。结果6例SPT中5例为女性、1例为男性,平均年龄34岁,瘤体平均直径9.3cm;光镜下瘤细胞圆形,大小较一致,无明显异型性,排列成实性片状区和假乳头状结构,假乳头轴心黏液变性,囊性区常见出血、坏死;其中1例除上述特征外还出现了大量的印戒细胞样瘤细胞,这些瘤细胞AB/PAS染色阴性,CEA阴性,S-100蛋白阴性,随访至今已4年余,无复发及转移。2例浸润包膜及周围胰腺组织;6例中3例有随访的均健在且无复发及转移。免疫组化检测:6例V im阳性(6/6),4例α-AT阳性(4/6),3例Syn阳性(3/6),1例CK弱阳性(1/6)、PR阳性(1/6),ER阴性(0/6),EMA阴性(0/6),CEA阴性(0/6),S-100蛋白阴性(0/6)。结论SPT好发于年轻女性;组织形态学特征为瘤细胞大小一致,排列成实性片状区与独特的假乳头状结构,偶见瘤细胞呈印戒细胞样,间质可黏液变性;该肿瘤生物学行为交界性或恶性潜能未定的肿瘤,即使出现包膜及周围胰腺浸润,预后亦较好。展开更多
目的:探讨胰腺实性假乳头状瘤(solid pseudo papillary tumor of the pancreas,SPTP)和胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)的超声表现特征,并比较分析两者之间超声影像要点。方法:回顾性分析2009年8月至2018年3月我...目的:探讨胰腺实性假乳头状瘤(solid pseudo papillary tumor of the pancreas,SPTP)和胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)的超声表现特征,并比较分析两者之间超声影像要点。方法:回顾性分析2009年8月至2018年3月我院经手术病理证实的48例SPTP患者和48例PDAC患者的超声检查结果,总结其超声声像图特征及两者之间的鉴别要点。结果:以病理检查结果为金标准,超声检查诊断SPTP及PDAC的符合率分别为68.8%(33/48)和85.4%(41/48)。在超声图像上,SPTP的发病部位、内部回声、钙化及肿块内部血流显示情况均与PDAC极为类似(P>0.05),但SPTP的边缘轮廓清晰率73.9%(34/46)和形态规则率73.9%(34/46)、液化率37.0%(15/42)均明显高于PDAC[28.6%(12/42)、35.7%(15/42)和7.1%(3/42)],而SPTP的主胰管扩张发生率低于PDAC[6.5%(3/46)比35.7%(15/42)],差异均有统计学意义(P<0.01)。上述超声特征中,液化特征鉴别SPTP与PDAC的特异度最高。结论:采用超声对SPTP与PDAC进行初步鉴别具有无创、方便、经济等优点,当超声检查显示胰腺肿块中伴有液化,且边缘清晰、形态规则者,应首先考虑SPTP可能。展开更多
目的:探讨胰腺实性假乳头状肿瘤(solid-pseudo-papillary tumor of pancreas,SPTP)的临床病理形态特征及免疫表型。方法:对5例SPTP患者的临床病理资料进行回顾性复习,并采用免疫组化SP法检测肿瘤细胞Vi m、NSE、a-AT、s-100、ck、EMA、...目的:探讨胰腺实性假乳头状肿瘤(solid-pseudo-papillary tumor of pancreas,SPTP)的临床病理形态特征及免疫表型。方法:对5例SPTP患者的临床病理资料进行回顾性复习,并采用免疫组化SP法检测肿瘤细胞Vi m、NSE、a-AT、s-100、ck、EMA、syn、CgA抗体的表达。结果:5例SPTP患者中,因腹部不适或腹部疼痛来医院就诊时发现2例,3例为常规体检时发现,女性4例,男性1例,平均年龄36岁,肿瘤位于胰头3例,胰尾2例,瘤体平均大小为8.7cm,镜下肿瘤细胞主要排列成实性片状及假乳头状结构,细胞无明显异型性,5例SPTP患者中1例为老年男性,镜下大部分肿瘤细胞胞浆透明,有的呈印戒样改变,形态较为特别,免疫组化显示,5例Vi m、NSE呈弥漫强阳性,4例a-AT呈小灶性阳性,2例ck呈弱阳性,1例syn灶性阳性,s-100、EMA、CgA均为阴性。结论:胰腺实性假乳头状肿瘤(SPTP)好发于年青女性,镜下瘤细胞主要排列成实性片状及假乳头状结构,是一种具有低度恶性潜能的病变,组织形态学特征和免疫组化对其诊断及鉴别诊断具有重要价值。展开更多
目的总结胰腺实性假乳头状瘤的外科治疗体会。方法45例胰腺实性假乳头状瘤患者，均行手术治疗，其中11例行胰腺局部切除术，20例行胰体尾切除术，5例行胰体尾联合脾脏切除术，9例行胰十二指肠切除术。结果8例发生消化不良，2例患者术后...目的总结胰腺实性假乳头状瘤的外科治疗体会。方法45例胰腺实性假乳头状瘤患者，均行手术治疗，其中11例行胰腺局部切除术，20例行胰体尾切除术，5例行胰体尾联合脾脏切除术，9例行胰十二指肠切除术。结果8例发生消化不良，2例患者术后发生胰瘘，胸腔积液2例，切口液化、感染2例，早期（术后24 h 内）消化道出血1例。所有患者均保守治疗均痊愈出院。43例获得随访，随访时间6～160个月，平均（41.5±1.5）个月，术后均无转移、复发及死亡。结论腺假乳头状瘤为潜在低度恶性肿瘤，好发于年轻女性，手术是唯一根治的治疗方式，预后一般较好。展开更多
文摘Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and 3 men) with pathologically proven solid pseudopapillary tumor of the pancreas were reviewed retrospectively. Two radiologists reviewed images for location, size and morphology, capsule and margin, density, enhancement pattern, calcification, dilatation of pancreatic duct, lymphadenopathy, vascular invasion, distant metastasis, and recurrence. Results On CT, the lesion presented as solitary, round (28.57%), oval (57.14%), or lobulated (14.28%) mass in pancreatic head (47.62%) with complete capsule (85.71%). Lesions smaller than 4cm in maximum diameter (47.62%) presented as predominantly solid mass whereas lesions greater than 4cm in diameter (52.28%) presented as heterogenous mass. On contrast administration, the viable solid portion of the tumor showed mild peripheral enhancement in arterial phase [enhancement degree<20Hounsfield unit (HU)] with progressive fill in during the portal and hepatic parenchyma phase (enhancement degree 20-40HU). Eighteen lesions (85.7%) had complete capsule. Two lesions (9.5%) had areas of high density (>60HU) on plain CT which due to hemorrhage. Dilatation of the pancreatic duct was rare (25%), and distant metastasis, regional lymphadenopathy, and tumor recurrence were absent. Nine patients (42.85%) had an abdominal CT follow-up for 24.55months (range, 2-60months) post-surgery without recurrence or distant metastasis. Conclusion Solid pseudopapillary tumor of the pancreas usually occurs in young females in the pancreatic head or tail. On CT, they manifest as moderate vascular mixed tumor, progressive enhancement of the viable solid portion, distinct tumor margin with capsule formation, and absence of regional lymphadenopathy.
文摘目的:探讨胰腺实性假乳头状瘤(solid pseudo papillary tumor of the pancreas,SPTP)和胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)的超声表现特征,并比较分析两者之间超声影像要点。方法:回顾性分析2009年8月至2018年3月我院经手术病理证实的48例SPTP患者和48例PDAC患者的超声检查结果,总结其超声声像图特征及两者之间的鉴别要点。结果:以病理检查结果为金标准,超声检查诊断SPTP及PDAC的符合率分别为68.8%(33/48)和85.4%(41/48)。在超声图像上,SPTP的发病部位、内部回声、钙化及肿块内部血流显示情况均与PDAC极为类似(P>0.05),但SPTP的边缘轮廓清晰率73.9%(34/46)和形态规则率73.9%(34/46)、液化率37.0%(15/42)均明显高于PDAC[28.6%(12/42)、35.7%(15/42)和7.1%(3/42)],而SPTP的主胰管扩张发生率低于PDAC[6.5%(3/46)比35.7%(15/42)],差异均有统计学意义(P<0.01)。上述超声特征中,液化特征鉴别SPTP与PDAC的特异度最高。结论:采用超声对SPTP与PDAC进行初步鉴别具有无创、方便、经济等优点,当超声检查显示胰腺肿块中伴有液化,且边缘清晰、形态规则者,应首先考虑SPTP可能。
文摘目的总结胰腺实性假乳头状瘤的外科治疗体会。方法45例胰腺实性假乳头状瘤患者，均行手术治疗，其中11例行胰腺局部切除术，20例行胰体尾切除术，5例行胰体尾联合脾脏切除术，9例行胰十二指肠切除术。结果8例发生消化不良，2例患者术后发生胰瘘，胸腔积液2例，切口液化、感染2例，早期（术后24 h 内）消化道出血1例。所有患者均保守治疗均痊愈出院。43例获得随访，随访时间6～160个月，平均（41.5±1.5）个月，术后均无转移、复发及死亡。结论腺假乳头状瘤为潜在低度恶性肿瘤，好发于年轻女性，手术是唯一根治的治疗方式，预后一般较好。
