论文部分内容阅读
目的探讨伴导管腺癌和破骨细胞样巨细胞的胰腺未分化癌的临床病理特征。方法对1例伴导管腺癌和破骨细胞样巨细胞的胰腺未分化癌进行临床、病理及免疫组化观察。结果患者男性,32岁。胃镜发现十二指肠降段菜花状肿块。切除标本示十二指肠与胰头之间有一8cm×6cm×5cm大小紫褐色肿物,质较脆,有出血坏死。镜下见肿瘤主要由两种成分构成,一种为分化较好的导管腺癌,免疫表型CK和EMA(+),vimentin(-);另一种为分化较差弥漫浸润的多形性癌细胞,免疫表型CK、EMA和vimentin(+),并见CD68和vimentin(+)的破骨细胞样多核巨细胞。结论伴有破骨细胞样巨细胞的胰腺未分化癌是胰腺导管腺癌的一个亚型,破骨细胞样巨细胞可能为反应性多核巨细胞,而非肿瘤性成分。
Objective To investigate the clinicopathological features of pancreatic adenocarcinoma and osteoclast-like giant cell carcinoma of the pancreas with undifferentiated carcinoma. Methods One case of undifferentiated pancreatic adenocarcinoma with osteoclast-like cells and pancreatic adenocarcinoma was observed by clinical, pathological and immunohistochemical methods. Results The patient was male, 32 years old. Endoscopy found duodenal cauliflower-like mass. Excision of specimens showed a duodenum and pancreatic head between the size of a 8cm × 6cm × 5cm purple brown mass, the quality of more brittle, bleeding necrosis. Microscopically, the tumor mainly consists of two components, one is well-differentiated ductal adenocarcinoma, immunophenotype CK and EMA (+), vimentin (-); the other is poorly differentiated diffuse infiltration of polymorphism Cancer cells, immunophenotype CK, EMA and vimentin (+), and see the osteoclast-like multinucleated giant cells of CD68 and vimentin (+). Conclusion The undifferentiated pancreatic adenocarcinoma with osteoclast-like giant cells is a subtype of pancreatic ductal adenocarcinoma. The osteoclast-like giant cells may be reactive multinuclear giant cells rather than neoplastic components.