摘要
目的 观察胰腺囊实性肿瘤的临床病理特点，分析其分化表型，探讨其组织发生。方法 组织学（ＨＥ、ＰＡＳ法） 、免疫组化（ＳＰ法）和电镜技术。结果 ８ 例患者均为女性，年龄１４ ～３３ 岁，平均２５ ．３ 岁，手术后均无复发。肿瘤较大（平均直径９．６ ｃｍ） ，有包膜，由实性肿瘤与囊性坏死区混合组成。组织学上，肿瘤细胞较一致，均由实性片块、假乳头样及两者的过渡型生长方式组成。瘤细胞退变、出血、泡沫细胞和胆固醇裂隙常见。免疫组化：８ 例均表达α１抗胰蛋白酶和溶菌酶，６ 例表达波形蛋白，２ 例表达肌动蛋白，１ 例肿瘤细胞巢中可见嗜铬粒素Ａ 阳性的细胞簇。孕激素受体和雌激素受体阳性者分别为８ 例和４ 例。低分子量角蛋白、高分子量角蛋白、上皮膜抗原、突触素、促肾上腺皮质激素、胃泌素、生长抑素、胰岛素、胰高血糖素均为阴性。电镜下３ 例均显示多形性分化，即肿瘤细胞分别向导管、腺泡和内分泌细胞分化，１ 例肿瘤细胞内见到ＷｅｉｂｅｌＰａｌａｄｅ 小体。结论 （１）胰腺囊实性肿瘤多发生于年轻女性、具有良性临床病程和较高手术治愈率的一个独特临床病理实体；（２） 胰腺囊实性肿瘤可能起源于胰腺多潜能干细胞，表现为导管。
Objective To study the clinicopathologic characteristics, differentiation patterns and histogenesis of cystic and solid tumors of the pancreas (CSTP). Methods 8 cases of CSTP were studied using histologic (HE and PAS), immunohistochemical (S P method) and electron microscopic techniques. Results All the patients were adolescent and young adult females, 14 33 years in age (mean 25.3 years) without recurrence after tumor resection. The mean diameter of tumors was 9.6 cm, all encapsulated. Histological examination showed presence of solid sheets, pseudopapillary, in all of the cases. Hemorrhage, foam cells, and cholesterol crystals were often found. Immunohistochemically, 8 cases were positive for α 1 AT and lysozyme; 6 cases expressed vimentin, 2 cases expressed actin, and CgA positive cells found in the tumor cell nests in one case. All of the cases showed PR, and 4 cases showed ER positive immunoreactivity in the majority of tumor cells, but negative for CK AE1, CK AE3, EMA, Synaptophysin, ACTH, gastrin, somatostatin, insulin, and glucogan in all the cases. Electron microscopy of 3 cases showed evidences of polymorphism in differentiation of the tumor cells, including the transitional apperance into ducts, acinus, and endocrine cells. Weibel Palade body found in tumor cells in one out of 8 cases. Conclusions (1) CSTP is a distinct clinicopathologic entity in young female patients with a benign clinical course. (2) CSTP develops from primitive pancreatic cells, with the potentiality of developing into ducts, acinus, and endocrine cells.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
1999年第6期409-412,共4页
Chinese Journal of Pathology
