无功能性胰岛细胞肿瘤伴类癌1例并文献复习

目的 探讨无功能性胰岛细胞肿瘤伴类癌的病理组织学、免疫组织化学特征.方法 对1例诊断无功能性胰岛细胞肿瘤伴类癌的病理组织学、免疫组织化学进行研究,并结合文献复习.结果 女性,36岁.巨检:(直肠黏膜下肿物)灰白色小组织0.6 cm×0.5 cm×0.4 cm;镜下:癌细胞较小均匀一致,呈多边形和卵圆形,胞浆中等量,核圆形深染,染色质分布均匀,无核仁和核分裂相;免疫组化:CgA( ),NSE( ).(胰腺肿瘤切除取材)肿物5 cm×4 cm×2.8 cm;近圆形,包膜完整;切面呈灰白,为囊实性.镜下:细胞组织排列方式多样.有的呈实性成片或弥漫状、腺样、岛状、条索状排列,由单层或双层瘤细胞构成互相吻合的带或索,其间为毛细血管.肿瘤间质黏液变性.瘤细胞较小圆形、多角形.大小、形态较一致.胞浆少、淡染,核圆形,染色质细颗粒状,偶见小核仁,未见核分裂.免疫组化:瘤细胞NSE( ),SYN( ),insulin瘤细胞(-),胰岛细胞( ),somatostatin(-),5-HT(-),PP(-),CK8(-),S-100(-).结论 无功能性胰岛细胞肿瘤伴类癌是临床非常罕见的疾病,尚未见报道,其诊断需结合病理组织形态、免疫表型特征、家族史及临床特征.

NONFUNCTIONAL LSLET CELL TUMOUR WITH RECTAL CARCINOID - A REPORT OF 1 CASE AND REVIEW OF THE LITERATURE

Objective To explore the clinical pathological and immunohistochemical characteristics of the nonfunctional islet cell tumour with rectal carcinoid.Methods One case of nonfunctional islet cell tumour with rectal carcinoid was studied on clinical pathological and immunohistochemical features with review of the literatures.Results Female patient,36 years old,Rectal tumour was composed of small-sized cells in uniformity,multiple and medium cytoplasm,Tumour cells contained chromatin in uniformity.No nucli and mitosis.Immunno-histochemically,the tumor cells were positive for CgA,NSE.Pancreatic tumor cells was arranged for lamellar,diffuse,or as islands,trabs.Monolayeral or bilayeral cells were associated as trabs,among them were capillaries.The mucid degeneration was in stoma. Cells were small,round and polygonal.Size and shape were uniform.The cytoplasm were rare,dim.Nuclei were round and small and polygonal.Their chromatin were granular.Small nucleoli were rare and no mitosis.Immuno-histochemistry showed that tumoural cells were positive for NSE,SYN,negative for S-100,CK8,insulin,somatostatin,5-HT and PP.Conclusions Non-functional islet cell tumor with carcinoid is very rare disease and no report.Its diagnosis depends on the combinating pathologic,immunophenotypic features,family history with clinical characteristics.