摘要
胰腺腺泡细胞癌(ACCP)是一种罕见的胰腺外分泌肿瘤,约占胰腺肿瘤的1%。ACCP典型的影像学表现为:(1)肿瘤体积较大,膨胀性生长,多突出于胰腺轮廓外;(2)可见完整或不完整包膜,增强扫描呈细线状强化;(3)密度及信号特点:CT表现为低密度,MR表现为长T1长T2信号;(4)强化方式:多数呈乏血供表现;(5)裂隙状、漩涡状坏死,可能为肿瘤特征性表现;(6)胰胆管扩张少见,多为外压性;(7)可侵犯邻近器官及胰腺周围血管等;(8)可有肝脏等部位远处转移;(9) PET-CT表现为FDG高摄取。北京协和医院于2015年11月至2017年8月收治了1例影像学表现不典型的ACCP患者,其术前多项影像学检查显示占位不明确,表现为等强化,最终经手术病理证实为ACCP。
Acinar cell carcinoma of pancreas(ACCP)is a rare pancreatic exocrine tumor that accounts for about 1%of pancreatic tumors.The typical imaging manifestations of ACCP are as follows:(1)the tumor is large in volume,partially or completely exophytic;(2)complete or incomplete capsule is visible with thin linear enhancement;(3)CT density and MRI signal:plain CT images reveals that the tumors have similar or slightly hypodense densities relative to the adjacent normal pancreas,the solid part of ACCP has low to intermediate signal intensity on T1WI and intermediate to high signal intensity on T2WI compared with the surrounding normal pancreas;(4)pattern of enhancement:tumors exhibit heterogeneous enhancement and it is less than that in the surrounding normal pancreas;(5)fissure-like,swirling necrosis that may be a characteristic change of tumor;(6)pancreatic and biliary duct dilatation is rare;(7)adjacent organs and blood vessels around the pancreas may be invaded;(8)distant metastasis of liver and other parts may be observed;(9)PET-CT shows high FDG uptake.An ACCP patient with atypical imaging manifestations was treated in Peking Union Medical College Hospital from November 2015 to August 2017.The lesion manifested iso-enhancement and many imaging examinations failed to find the tumor.The patient ultimately underwent surgery and diagnosed as ACCP by pathology.
作者
李娟
常晓燕
朱亮
戴梦华
薛华丹
LI Juan;CHANG Xiaoyan;ZHU Liang;DAI Menghua;XUE Huadan(Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Pathology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of General Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2018年第5期714-718,共5页
Acta Academiae Medicinae Sinicae
关键词
腺泡细胞癌
胰腺
影像学表现
acninar cell carcinoma
pancreas
imaging manifestations
