胰腺浆液性微囊性腺瘤临床病理学观察

目的 探讨胰腺浆液性微囊性腺瘤(serous microcystic adenoma,SMA)的临床与病理学特点.方法 对12例SMA进行临床病理、特殊染色及免疫组化观察并随访.结果 ①临床:12例SMA中,男3例、女9例,35～70岁,平均51.5岁;7例因体检发现,5例因上腹不适或疼痛就诊;肿瘤直径2.0～13 cm,平均6.0 cm,切面均呈蜂窝状,囊内含清亮液体或灰红色液体.②镜下:瘤组织由多量小囊腔构成,囊壁内衬单层立方或扁平上皮,胞浆透亮,富含糖原,部分嗜酸,核小而圆,深染,大小一致,无明显异型性,核分裂像极少或无.③特殊染色:瘤细胞PAS(+),AB-PAS(-).④免疫组化:AEl/AE3及EMA(+),CEA、Vimentin、CgA、Syn、CD34、P53及S-100均(-).10例病人随访12～71个月,均未见复发.结论 SMA为胰腺罕见的肿瘤,临床上多无明显症状,依据其特有的病理组织学形态及免疫组化染色可明确诊断.其具体生物学行为有待进一步研究.

Clinicopathological observation of serous microcystic adenoma of pancreas

Objective To investigate the clinicopathologieal features of serous microcystic adenoma of the pancreas. Methods Clinicopathological analysis, histochemieal and immunohistochemical studies were performed in 12 cases of serous microcystic adenoma of the pancreas with follow-up. Results The patients included 9 females and 3 males who ranged in age from 35 to 70 (mean=51.5). Seven patients were discov-ered by check-up incidentally and 5 for the symptoms as upper abdominal uncomfortable or pain. Tumors varied in size from 2.0 cm to 13 cm in maximal diameter(mean=6.0 cm), and all had a multicystic appear-ance. Histologically, all tumors were composed of numerous microcysts lined by a single layer of cuboidal or flattened cells. The tumor cells contained clear cytoplasm with glycogen and centrally located round nuclei mostly uniform without any atypia. Mitoses were very rare or absent. Histochemically, the tumor cells were positive for PAS and negative for AB-PAS. Immunohistochemieally, the tumor cells revealed diffuse positivi-ty of cytokeratins and epithelial membrane antigen, whereas CEA, CgA, Syn, CD34, Vimentin, P53 and S-100 protein were negative. Follow-up in 10 patients (range from 12 to 71 months) showed no recurrence of serous cystadenomas. Conclusion Serous microcystic adenoma of the pancreas is an extremely rare tumor. It is often non-symptomatic. Its diagnosis is mainly dependent on its unique morphological immunohistochemical features. It's biology behavior is necessary to study.