文章摘要
郑金榆,柏 涛,陈 鸣,吴鸿雁,林 旭,章宜芬,孟凡青.胰腺实性-假乳头状肿瘤的内镜超声引导下细针穿刺细胞学特征[J].南京医科大学学报,2015,(9):1278~1282
胰腺实性-假乳头状肿瘤的内镜超声引导下细针穿刺细胞学特征
Endoscopic ultrasound-guided fine needle aspiration cytology of solid-pseudopapillary neoplasms of the pancreas
投稿时间:2015-06-04  
DOI:10.7655/NYDXBNS20150921
中文关键词: 胰腺肿瘤  实性-假乳头状肿瘤  细胞病理学
英文关键词: pancreatic neoplasms  solid-pseudopapillary neoplasm  cytopathology
基金项目:江苏省第八批六大人才高峰高层次人才资助(D类)项目
作者单位
郑金榆 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
柏 涛 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
陈 鸣 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
吴鸿雁 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
林 旭 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
章宜芬 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
孟凡青 南京大学医学院附属鼓楼医院病理科,江苏 南京 210008 
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中文摘要:
      目的:探讨胰腺实性-假乳头状肿瘤(solid-pseudopapillary neoplasms,SPN)的内镜超声引导下细针穿刺(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)细胞学特征?免疫细胞化学特点及鉴别诊断。方法:对7例EUS-FNA细胞学诊断为SPN并经组织病理学证实病例进行细胞病理学和免疫细胞化学观察,并复习文献。结果:SPN的EUS-FNA结果显示细胞量大都丰富,肿瘤细胞温和?小而一致,细胞呈圆形或形似浆细胞。细胞核圆形或卵圆形,核膜光滑,染色质细颗粒状,分布均匀,核仁不明显。胞浆常较丰富,苍白至粉红色颗粒状,其内可见空泡。肿瘤细胞或散在分布,或形成玫瑰花环(腺泡样)结构,或形成特征性的具有纤维血管轴心的乳头状结构。5例肿瘤行免疫细胞化学染色,结果显示:5例vimentin?progesterone receptor(PR)?β-catenin?CD10?α-1-antitrypsin阳性;4例CD56强阳性,1例局灶弱阳性;3例CD99核旁点状阳性;synaptophysin强弱不等的阳性;2例chromogranin A 弱阳性;2例cytokeratin AE1/AE3散在阳性。结论:胰腺SPN的EUS-FNA细胞形态学特点主要表现为小而一致的肿瘤细胞散在分布或形成具有纤维血管轴心的乳头状结构。鉴别诊断包括胰腺神经内分泌肿瘤?腺泡细胞癌等。免疫细胞化学β-catenin呈核阳性表达,CD10?CD56?vimentin?PR阳性及CD99核旁点状阳性表达可有助于SPN的诊断。
英文摘要:
      Objective:To investigate cytologic features,immunocytochemical profiles and differential diagnoses of solid-pseudopapillary neoplasms (SPN) of the pancreas in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)specimen. Methods:The cytopathological and immunocytochemical features were studied in 7 cases of SPN,who were diagnosed by EUS-FNA cytology and were confirmed by histopathology. Results:Samples of EUS-FNA gotten from SPN were usually highly cellular. Tumor cells were usually small and uniform,round-to-plasmacytoid,had pale-to-granular cytoplasm with vacuoles. The nuclei of neoplastic cells were usually round or orbicular-ovate,with smooth contours,fine and evenly dispersed granular chromatin. Nucleoli were not seen or inconspicuous. The neoplastic cells were presented as diffused distribution,rosette/acinar pattern,and more specifically,papillae with fibrovascular cores. Immunocytochemical staining was performed on 5 cases. Vimentin,progesterone receptor,β-catenin,CD10,CD56 and α-1-antitrypsin showed strong positivity in all 5 cases,and synaptophysin,chromogranin A,cytokeratin AE1/AE3 as well as CD99 variable positivity in some of the cases. Conclusion:Cyto-morphological characteristics of SPN includes small uniform tumor cells,which are disperse or arranged in papillae with fibrovascular cores. Differential diagnoses of SPN include pancreatic endocrine neoplasm and acinar cell carcinoma etc. The expression of β-catenin,CD10,CD56,vimentin,progesterone receptor and CD99 can promote the diagnosis of SPN.
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