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目的探讨胰腺浆液性及黏液性囊性肿瘤的临床及病理学特点。方法回顾性分析35例胰腺浆液性及黏液性囊性肿瘤的临床及病理资料。结果 35例患者平均年龄为54岁,男女之比为1∶1.77。肿瘤位于胰头7例(20%),胰颈4例(11.4%),胰体尾24例(68.6%)。临床影像学表现均为胰腺囊性占位。所有患者均行手术治疗,其中浆液性囊腺瘤27例(77.1%)(微囊型20例、寡囊型7例),黏液性囊性肿瘤伴异型增生8例(22.9%)(伴低级别异型增生6例、伴中级别异型增生2例)。浆液性囊腺瘤为多房囊性,囊壁衬覆扁平或立方上皮,胞质透亮,核圆形或卵圆形,无明显异型和核分裂。黏液性囊性肿瘤伴低级别异型增生为多房囊性,囊壁衬覆柱状上皮,细胞核增大、位于基底部,胞质内含有黏液,囊壁内有富于细胞的卵巢样间质;伴中级别异型增生者可见乳头状突起及隐窝样凹陷形成,细胞排列呈假复层,核拥挤、增大,可见核分裂。30例经6个月至4年的随访未发现肿瘤复发或转移,5例术后痊愈,随访失联。结论胰腺浆液性及黏液性囊性肿瘤相对少见,掌握临床病理特征有助于准确的病理诊断。
Objective To investigate the clinical and pathological features of pancreatic serous and mucinous cystic tumors. Methods The clinical and pathological data of 35 cases of pancreatic serous and mucinous cystic tumors were retrospectively analyzed. Results The average age of 35 patients was 54 years old, the ratio of male to female was 1: 1.77. Tumors were located in the pancreas in 7 cases (20%), pancreas in 4 cases (11.4%) and pancreas in 24 cases (68.6%). Clinical imaging findings were pancreatic cystic lesions. Surgical treatment was performed in all patients, including 27 cases (77.1%) of serous cystadenocarcinoma (20 cases of microcapsules, 7 cases of oligohydrocapsa) and 8 cases (22.9%) of myxoid cystic tumors with dysplasia 6 cases of atypical hyperplasia and 2 cases of middle-class dysplasia). Serous cystadenoma multi-atrial cysts, wall lining flat or cubic epithelium, cytoplasmic translucent, round or oval nucleus, no significant heterotypic and mitotic. Myxoid cystic tumors with low-grade dysplasia of multiple atrophic cysts lining the columnar epithelium, nucleus increased, located in the basal part of the cytoplasm containing mucus, cytoplasm rich in cells ovarian interstitial; Patients with mid-level dysplasia can be seen papillary processes and crypt-like depression formation, cells arranged in pseudostratified, nuclear crowded, increased, showing nuclear fission. Tumor recurrence or metastasis was found in 30 cases after 6 months to 4 years of follow-up. Five cases recovered after surgery and were lost in follow-up. Conclusions Pancreatic serous and mucinous cystic neoplasms are relatively rare. To master the clinicopathological features is helpful for the accurate pathological diagnosis.