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目的探讨胰腺实性假乳头状肿瘤(SPN)的临床病理学特征及其鉴别诊断。方法回顾性复习2004-2013年间收集的10例SPN临床资料、镜下形态和免疫表型特点,分析预后。免疫组化标记采用En Vision法。结果患者女性7例,男性3例。肿瘤界限清楚,切面囊实性,浅灰红色,9例包膜完整,1例见包膜侵犯。组织学上,肿瘤呈实性巢片状和假乳头状结构,瘤细胞形态一致。免疫组化CD99呈特异性瘤细胞核旁逗点着色,β-caternin易位表达—瘤细胞胞浆和胞核着色,瘤细胞均表达CD10、PR、CD56、AE1/3、Vimentin、NSE、α-ACT,不表达E-cadherin和CK7。随访10例,1例局部复发,无转移。结论 SPN是一种较少见的具有低度恶性潜能的肿瘤,好发于年轻女性,亦可见于老年男性,其特征性免疫组化表型谱:CD99、β-caternin、PR和CD10有助于SPN的诊断以及与胰腺神经内分泌肿瘤的鉴别。
Objective To investigate the clinicopathological features and differential diagnosis of solid pseudopapillary tumor of pancreas (SPN). Methods The clinical data of 10 cases of SPN collected from 2004 to 2013 were retrospectively reviewed. The morphological and immunophenotypic features were analyzed retrospectively. Immunohistochemistry using En Vision method. Results The patients were 7 females and 3 males. Clear tumor boundaries, section of cystic solid, light gray-red, 9 cases of complete capsule, 1 case of envelope invasion. Histologically, the tumor was solid nest-like and pseudopapillary structure, tumor cells in the same form. The expression of CD10, PR, CD56, AE1 / 3, Vimentin, NSE, α-SMA in tumor cells were all marked by immunohistochemical staining of CD99. ACT, but not E-cadherin and CK7. Follow-up in 10 cases, 1 case of local recurrence, no metastasis. Conclusions SPN is a rare tumor with low malignant potential, appearing in young women and also in elderly men. Its characteristic immunohistochemical phenotypes are: CD99, β-caternin, PR and CD10 In the diagnosis of SPN and the identification of pancreatic neuroendocrine tumors.