胰腺原发性神经鞘瘤六例病理学特征

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目的:探讨胰腺原发性神经鞘瘤的临床病理特征。方法:回顾性分析2010年10月至2017年9月间海军军医大学第一附属医院收治的6例胰腺神经鞘瘤的临床病理学资料,采用免疫组织化学法检测间叶标志物vimentin和神经源性标志物S100、ABC、β-tub、NGFR、SOX10及CDn 34、CDn 117的表达。n 结果:6例胰腺神经鞘瘤中男性2例,女性4例,男女比例1∶2,发病年龄36~76岁,中位年龄48岁。肿瘤位于胰头1例,胰颈2例,胰体2例,胰尾部1例。术前影像学检查示6例均为单发,其中3例为实性,3例为囊实性。5例行根治性手术,1例行肿瘤剜除术。大体标本见肿瘤与周围组织界清,切面呈淡黄色,半透明,可伴出血及囊性变。显微镜下可见典型的A区(束状区)及B区(网状区)结构。免疫组织化学染色结果显示,vimentin、S100、ABC、β-Tub、SOX10均呈阳性表达,CDn 34及CDn 117均呈阴性表达,4例NGFR呈阳性表达,2例阴性表达。患者预后较好,均未见肿瘤复发及转移。n 结论:胰腺神经鞘瘤具有明显的病理学特征,预后较好。“,”Objective:To investigate the clinicopathological features of primary pancreatic schwannoma.Methods:The clinicopathological features of 6 cases with pancreatic schwannoma admitted in the First Affiliated Hospital of Naval Medical University from October 2010 to September 2017 were retrospectively analyzed. The expressions of mesenchymal marker vimentin and neurogenic markers including S100, ABC, β-tub, NGFR, SOX-10 and CD n 34, CDn 117 were detected by immunohistochemistry.n Results:In the 6 cases of pancreatic schwannoma, there were 2 men and 4 women. The male to female ratio was 1∶2. The patient age ranged from 36 to 76 years old, and the median age was 48 years old. One tumor was located in the head, two in the neck, two in the body and one in the tail of pancreas. Preoperative imaging findings showed that the 6 cases of pancreatic schwannoma were all single lesion, 3 were solid, and the other 3 were cystic solid. Among the 6 cases, 5 cases underwent radical operation and 1 case underwent tumor resection. Macroscopically, the mass was clearly separated from the surrounding tissue, and the section surface was yellowish, translucent with hemorrhage and cystic changes. Microscopicalliy, typical features of pancreatic schwannoma included A region (zona fasiculata) and B region (zona reticularis). The immunohistochemical results found the positive staining of vimentin, S100, ABC, β-Tub and SOX-10, negative staining of CD n 34 and CDn 117. NGFR was positively expressed in 4 cases but negatively expressed in 2 cases. All patients had a good prognosis. No recurrence or metastasis was observed.n Conclusions:The pathological features of pancreatic schwannoma was obvious and the clinical prognosis was good.
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