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目的 :探讨胰母细胞瘤的病理形态特征、鉴别诊断。方法 :对 1例成人胰母细胞瘤进行病理组织学观察与免疫组织化学检测 ,结合文献讨论了其病理形态特点 ,鉴别要点及特殊的临床表现。结果 :胰母细胞瘤的瘤细胞由上皮和间叶两种成分组成 ,排列呈巢状和小叶状 ;上皮成分分化成特征性的鳞状小体结构及腺管 ,腺泡状 ,其多表达上皮性标记如CK ,EMA ,部分表达Syn、CgA等内分泌标记 ,而不表达vimentin ;上皮成分周围可见疏松的圆形或短梭形小细胞 ,表达少量的SMA、Des,提示有平滑肌分化 ,并有部分表达CD6 8。结论 :胰母细胞瘤是一种罕见的胰腺恶性肿瘤 ,鳞状小体为其特征性的组织学改变 ,具有多向分化的特征 ,其可能起源于原始多潜能细胞。
Objective: To investigate the pathological features and differential diagnosis of pancreatic blastoma. Methods : One case of adult pancreaticoblastoma was examined histopathologically and immunohistochemically. The pathological features,discrimination points and special clinical manifestations were discussed in the literature. RESULTS: The tumor cells of pancreoblastoma consisted of epithelial and mesenchymal components. The arrangement was nested and lobulated; the epithelial components differentiated into characteristic squamous structures and glandular and alveolar-like structures. Epithelial markers such as CK, EMA, partial expression of Syn, CgA and other endocrine markers, but not expression of vimentin; epithelial cells surrounded by loose round or short spindle-shaped small cells, expression of a small amount of SMA, Des, suggesting smooth muscle differentiation, and Some of them express CD6 8. Conclusions: Pancreoblastoma is a rare pancreatic malignancy. Its squamous corpuscles are characterized by histological changes and have multi-directional differentiation characteristics. It may originate from primitive pluripotent cells.