胰腺实性假乳头状瘤11例临床病理分析

目的探讨胰腺实性假乳头状瘤(solid-pseudopapillary tumor of pancreas,SPTP)的临床病理特征、组织来源及预后。方法回顾性分析11例SPTP的临床病理特征及免疫组化结果,并结合临床随访信息评价治疗与预后。结果11例中10例女性,1例男性,平均年龄24.7岁(8~50岁)。肿瘤囊实性,镜下1例可见侵犯包膜及神经,1例侵及十二指肠,5例侵及周围胰腺组织。组织学上,肿瘤细胞形态较单一,呈实性巢片状和假乳头状结构。免疫组化:11例SPTP中11例vimentin、ACT( ),10例CD10( )、NSE( ),9例Syn( )、AAT( ),8例AE1/AE3、CD56( ),8例S-100、EMA( ),4例ChrA( ),6例PR( ),ER均为(-)。结论SPTP为主要发生于年轻女性、具有低度恶性潜能的少见肿瘤。组织学具有特征性的实性、假乳头状结构。免疫组化检测对其组织源性具有提示意义,并可辅助诊断。

Solid-pseudopapillary tumor of pancreas: a clinicopathologic study of 11 cases

Objective To study the clinicopathologic features,histogenesis and prognosis of solid pseudopapillary tumor of the pancreas(SPTP).Methods 11 cases of SPTP were analysized retrospectively with clinicopathologic features and immunohistochemical results,Therapeutic approach and prognosis were also studied.Results There were ten females and one male with a median age of 24.7 years(range 8-50).Both tumors were all cystic and solid masses.1 case invaded the capsule and nerve,1 case invaded duodenum,and 3 cases invaded the surrounding normal pancreatic parenchyma.Histologically,the tumors were composed of monomorphic cells forming solid sheets and pseudopapillary structures.Immunohistochemically,the tumors were positive for vimentin(11 cases),ACT(11 cases),CD10(10 cases),AAT(9 cases),Syn (9 cases),S-100(8 cases),NSE(8 cases),CD56(8 cases),AE1/AE3(8 cases),EMA(6 cases),ChrA(4 cases);PR(6 cases),and all of cases were all negative for ER. Conclusions SPTP is an uncommon neoplasm of low malignant potential,generally occurring in young women.There are solid and pseudopapillary structures in histology.Immunohistochemical study suggests the origin and immunohistochemistry is important to the diagnosis of the SPTP.