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目的探讨十二指肠原发性腺鳞癌病理学特征及其诊断、治疗。方法对1例十二指肠原发性腺鳞癌行组织病理学检查,并结合文献讨论。结果肿瘤紧邻十二指肠乳头,大小4.5 cm×3.5 cm。镜检:肿瘤由分界清楚、形态典型的多角形鳞状细胞和腺癌细胞组成,癌巢内可见坏死组织。肿瘤细胞侵犯十二指肠全层,其中黏膜层和黏膜下层以腺癌成分为主,而肌层和浆膜层则主要是鳞状细胞癌,胰腺周围淋巴结见鳞状细胞癌成分转移,胰腺内亦可见到鳞状细胞癌成分,而其余组织均未见肿瘤成分。结论十二指肠腺鳞癌是一种少见的恶性肿瘤,具有明确的形态学特征,即肿瘤由腺癌和鳞癌成分共同组成,且每种形态超过肿瘤的1/3。
Objective To investigate the pathological features of primary adenosquamous carcinoma of the duodenum and its diagnosis and treatment. Methods One case of primary adenosquamous carcinoma of the duodenum was examined by histopathology and combined with literature review. Results The tumor was immediately adjacent to the duodenal papilla and was 4.5 cm × 3.5 cm in size. Microscopic examination: tumor from the demarcation is clear, the typical shape of polygonal squamous cells and adenocarcinoma cells, necrotic tissue can be seen within the cancer nest. Tumor cells invaded the duodenum, of which mucosal and submucosal adenocarcinoma composition, and muscle and serosa mainly squamous cell carcinoma, pancreatic lymph nodes see squamous cell carcinoma metastasis, the pancreas Squamous cell carcinoma can also be seen within the composition, while the rest of the organization were no tumor composition. Conclusions Adenosquamous carcinoma of the duodenum is a rare malignant tumor with definite morphological characteristics. That is, the tumor consists of adenocarcinoma and squamous cell carcinoma, and each form is more than 1/3 of the tumor.