5例胰腺实性假乳头状肿瘤的临床病理分析

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。

Clinical Pathological Analysis of Solid Pseudo Papillary Tumor of Pancreas in 5 cases

Objective :To study the clinical pathologic characteristics and Immunophenotype of solid pseudo papillary tumor of pancreas(SPTP).Methods:The clinical and pathologic data were retrospectively reviewed in 5 cases of SPTP.The expression of Vim、NSE、a-AT、S-100、ck、EMA、syn and CgA protein were detected by using immunohistochemistry S-P methods.Results:Because of abdominal discomfort or abdominal pain to hospital and found 2 cases and 3 cases of routine physical examination found of 5 cases of SPTP.4 cases were female 1 case of male,with average age of 36 years,In three cases of pancreatic head cancer,pancreatic tail in 2 cases,the average tumor size of 8.7cm,Endoscopic tumor cells arranged in solid sheets and pseudo papillary structures,cells no obvious atypia,1 male were elderly patients of 5 cases of SPTP cases,most of the cytoplasm of tumor cells and transparent,and some showed signet-ring-like change,shape is more special,Immunohistochemistry showed that 5 cases of Vim,NSE showed diffuse strong positive,4 cases of special treatment was a-AT positive,2 cases ck weakly positive,1 case syn focal positive,s-100,EMA,CgA were all negative.Conclusion:The solid pseudo papillary tumor(SPTP)occur in the young women,microscopic tumor cells are mainly arranged in solid sheets and pseudo papillary structures,is a kind of low-grade malignant potential of lesions,morphological characteristics and immunohistochemistry have significant value in its diagnosis and differentia diagnosis.