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胰管内乳头状肿瘤包括胰管内乳头状瘤、弥散性胰管内乳头状腺癌及胰腺原位癌,临床上相对少见,且可经全胰切除而治愈。作者报道了6例胰管内乳头状肿瘤的诊治体会。男女各3例,平均73(64～79)岁,其中4例因疑为胰腺癌而作全胰切除术,1例为肝硬化伴肝细胞癌,1例在尸检时发现胰腺肿瘤。胰腺肿瘤切除标本作组织学、免疫细胞化学及电镜检测。结果如下。6例胰腺切除标本显示胰腺增厚,呈结节状且质地坚硬,切面有单个或多个肿瘤,其中4例患者的胰管内肿瘤从乏特氏壶腹部扩展至胰体部。肿瘤较软,质脆,呈褐色及灰白色,分泌粘液的肿瘤局限于胰管壁,无明显侵犯胰腺实质及转移。光镜下,胰管内肿瘤为一种分化良好的乳头状或乳头管状肿瘤。乳头的纤维血管蒂由卵圆形和少数多形性核位于基底部的柱状上皮细胞组成,有丝分裂少见,偶见核假
Pancreatic duct papillary tumors include intrapancreatic papilloma, diffuse intrapancreatic papillary adenocarcinoma, and pancreatic carcinoma in situ, which are relatively rare in clinical practice and can be cured by total pancreatectomy. The authors reported on the diagnosis and treatment of 6 cases of intrapancreatic papillary tumors. There were 3 males and 3 females, with an average age of 73 (64-79) years. Among them, 4 patients had suspected pancreatic cancer for pancreatic resection, 1 had liver cirrhosis with hepatocellular carcinoma, and 1 had pancreatic tumor at autopsy. Pancreatic tumor resection specimens for histology, immunocytochemistry and electron microscopy. The result is as follows. Six cases of pancreatic resection showed thickening of the pancreas, nodular and hard texture, single or multiple tumor sections, of which four cases of pancreatic duct tumors from the ampulla of pterygota extended to the pancreatic body. The tumor was soft, brittle, brownish and gray-white, and the mucin-secreting tumor was confined to the pancreatic duct wall, with no significant violation of pancreatic parenchyma and metastasis. Under light microscope, the pancreatic duct tumor is a well-differentiated papillary or papillary tubular tumor. The fibrovascular pedicle of the papilla is composed of columnar epithelial cells in the base of the oval and a few polymorphous nuclei, with rare mitosis and occasional nuclear false