起源并局限于主胰管内的癌肿不常见,作者报告4例主胰管癌,讨论其临床病理特征及鉴别诊断。本组男3例,女1例,年龄25～72岁,平均64岁。最常见的临床表现是上腹痛几个月至几年,3例病人术前几周出现黄疸,第4例术前二年曾出现一次持续15天的黄疸。3例ERCP,CT均见胰管扩张,扩张远端直到管内肿块所致的狭窄部。肉眼内主胰管被乳头 Tumors of origin and confined to the main pancreatic duct are uncommon. The authors report 4 cases of primary pancreatic duct carcinoma, discussing their clinicopathological features and differential diagnosis. This group of 3 males and 1 female, aged 25 to 72 years, an average of 64 years old. The most common clinical manifestations were epigastric pain from several months to several years. Three patients had jaundice in the first few weeks of surgery. In the fourth case, there was a jaundice lasting 15 days before surgery. In 3 cases of ERCP and CT, the pancreatic duct was dilated and the distal part was expanded until the stenosis due to intraluminal mass. The main pancreatic duct is nippled in the naked eye