胰腺实性—假乳头状肿瘤8例临床病理学分析

目的探讨胰腺实性-假乳头状肿瘤(solid-pseudopapillary tumor of pancreas,SPTP)的临床病理学特点、诊断和鉴别诊断、治疗及其预后。方法对8例SPTP患者的临床、病理学特点及免疫组化结果进行研究,并复习相关文献。结果 8例均为女性,年龄19～38岁,平均28岁。肿块直径3～15 cm。镜下肿瘤由乳头区和囊实区混合组成,瘤细胞围绕纤维血管轴心形成特征性假乳头结构。免疫表型:CK(3/8)、vimentin(8/8)、NSE(8/8)、CD56(8/8)、ER(0/8)、PR(5/8)、α-AT(8/8)、CgA(1/8)、Syn(8/8)、E-cadherin(0/8)、β-连环蛋白(8/8)和cyclinD1的核阳性率均大于40%。随访6例患者17～131个月,均无肿瘤复发及转移,并存活至今。结论 SPTP是一种好发于年轻女性,具有低度恶性潜能的少见胰腺肿瘤,其病理形态特征和免疫组化标记对SPTP的诊断和鉴别诊断具有重要价值。

Solid-pseudopapillary tumor of pancreas:a clinicopathological analysis of 8 cases

Purpose To investigate the clinicalpathologic features,diagnosis,differential diagnosis,therapy and prognosis of solid-pseudopapillary tumor of pancreas(SPTP).Methods The clinical history,histopathological features and immunohistochemical characteristics were analyzed in 8 cases of SPTP,and related literature were reviewed.Results There were 8 female patients,aged from 19~38 years(mean 28).The sizes of tumors were from 3.5~15 cm.Histologically,they were composed of papillary and microcystic solid structures.Pseudopapilla with a fibro-vascular core was remarkable.Immunohistochemically,the tumors expressed CK(3/8),vimentin(8/8),NSE(8/8),CD56(8/8),ER(0/8),PR(5/8),α-AT(8/8),CgA(1/8),Syn(8/8),E-cadherin(0/8),and β-cantenin(8/8).Positive rates of cyclinD1 were all more than 40% in tumor cells.All the patients were followed up for a period of 17~131 months,and they were all alive,had no recurrence and metastasis.Conclusions SPTP is a distinct clinicopathologic entity preferentially in young adult female patients,with low malignant potential.Pathological morphology and immunohistochemistry are very important in the diagnosis and differential diagnosis of SPTP.