胰腺囊实性肿瘤的诊断和治疗

目的探讨CSTP的临床病理特征、鉴别诊断及治疗方法。方法 对1例CSTP进行CT、大体、光镜观察并复习相关献。结果 该瘤界限清楚，有包膜，由实性区与囊性坏死区混合组成。组织学上，肿瘤细胞排列呈多种结构(实性片块状，囊状，小梁状和假乳头状)。瘤细胞大小形态较一致，核圆形或卵圆形，核异型性不明显，核分裂象罕见。胞浆透明或嗜酸性。肿瘤内出血、泡沫细胞聚集和胆固醇结晶。免疫组化：瘤细胞Lysozyme、Vimentin、Syn阳性，NSE、EMA、Keratin、CgA均为阴性。结论 胰腺囊性实性肿瘤是一类具有独特的临床病理特征的新的肿瘤实体，主要发生于青春期女孩和年轻妇女，有良性临床病程、手术治愈率较高，可能起源于胰腺多潜能干细胞。

Diagnosis and Treatment of Cystic and Solid Tumors of the Pancreas

Objective To study the clinical pathological features, diagnosis and treatment of solid - cystic tumors of pancreas. Methods A case of CSTP was presented by CT and light microscopy and discussed grossly, with review of the literature. Results Tumor was grossly well circumscribed by a capsule and was cystic and solid masses. Histological examination reveals a variety of patterns ( solid sheets, cystic, trabecular and pseudopapillary). The tumor cells were fairly bland, small to medium - sized and polygonal to elongated, with regular round - to - ovoid nuclei that often were grooved or indented. Nucleoli were inconspicuous. Mitotic figures were extremely rare. The cytoplasm ranged from clear to eosinophilic. Hemorrhage, croups of foamy macrophages accumulate and clusters of lipid crystals were often found. Immunohistoehemieally, Lysozyme, Vimentin, Syn and NSE were positive, Keratin, EMA, Actin and CgA were negative. Conclusion CSTP is an increasingly recognized entity with distinct and highly characteristic clinicopathologic features in adolescent girls and young women, with a benign clinical course as well as an excellent prognosis after complete surgical removal of the tumor. CSTP develops from multipotential primitive pancreatic cells and is a sex hormone responsive tumor.