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[目的]探讨胰腺浆液性微囊性腺瘤临床病理特点、诊断及鉴别诊断要点。[方法]对德清县人民医院外检所遇3例胰腺浆液性微囊性腺瘤进行临床病理分析。[结果]胰腺浆液性微囊性腺瘤好发于老年女性,临床症状不明显。病理检查肿瘤为大小不等海绵状小囊,衬覆扁平或低立方上皮细胞及肌上皮,细胞无异型性,囊壁间为粗大的纤维结缔组织间隔。免疫组化显示囊壁细胞EMA(上皮膜抗原)和Keratin(角蛋白)阳性;CA199(糖链抗原19-9)、ER(雌激素受体)、PR(孕激素受体)和Ⅷ因子(凝血因子Ⅷ)阴性,Ki-67阳性低于2%。[结论]胰腺浆液性微囊性腺瘤临床罕见,其诊断和鉴别诊断主要靠病理组织学和免疫组化检查,结合术前影像学结果。
[Objective] To investigate the clinical and pathological features, diagnosis and differential diagnosis of pancreatic serous microencapsulated adenoma. [Method] The clinicopathological analysis of 3 cases of pancreatic serous microencapsulated adenoma occurred in Deqing County People’s Hospital. [Results] Pancreatic serous microencapsulated adenoma mainly occurred in elderly women, but the clinical symptoms were not obvious. Pathological examination of tumors ranging in size from sponge-like sac, lining flat or low-cubic epithelial cells and myoepithelial cells without atypia, between the walls of thick fibrous connective tissue space. Immunohistochemistry showed that cyst wall cells were positive for EMA (epithelial membrane antigen) and Keratin (keratin); CA199 (glyco antigen 19-9), ER (estrogen receptor), PR (progesterone receptor) and factor VIII Factor VIII) negative, Ki-67 positive less than 2%. [Conclusion] Pancreatic serous microencapsulated adenoma is rare in clinic. The diagnosis and differential diagnosis of pancreatic serous microencapsulated adenoma mainly rely on histopathology and immunohistochemistry, combined with preoperative imaging results.