The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications an...The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. Surgery is indicated for all MCNs.展开更多
目的探讨肾混合性上皮和间质肿瘤(mixed epithelial and stromal tumor of the kidney,MESTK)临床病理特征。方法收集5例MESTK的临床资料及随访结果,采用HE染色及免疫组织化学染色,观察组织学特征及免疫组织化学特点,并复习相关文献。结...目的探讨肾混合性上皮和间质肿瘤(mixed epithelial and stromal tumor of the kidney,MESTK)临床病理特征。方法收集5例MESTK的临床资料及随访结果,采用HE染色及免疫组织化学染色,观察组织学特征及免疫组织化学特点,并复习相关文献。结果5例均为女性,年龄44~62岁,平均51.2岁。临床表现主要为腰背部疼痛及血尿,影像学检查提示肾脏囊实性占位。病理大体表现为肾脏界线清楚的囊实性肿瘤,多位于肾中极;组织学特征:肿瘤由上皮和间质成分混合构成,上皮排列成小管、微囊、大囊、乳头等结构,间质由梭形细胞组成,疏密不一,可见卵巢样间质、间质水肿及慢性炎症细胞浸润,上皮及间质细胞均未见明显异型性。免疫组织化学:上皮细胞表达广谱细胞角蛋白(CK_(pan))、CK7、PAX-8、P504S,间质细胞大多表达结蛋白(desmin)、平滑肌肌动蛋白(SMA)、雌激素受体(ER)、孕激素受体(PR)、CD10,Ki-67增殖指数低。结论MESTK是一种罕见的良性肾脏肿瘤,好发于围绝经期女性,影像学检查常误诊为囊性肾癌,有独特的病理组织学和免疫组织化学表现,肿物完整切除后,预后良好。展开更多
文摘The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. Surgery is indicated for all MCNs.
文摘目的探讨肾混合性上皮和间质肿瘤(mixed epithelial and stromal tumor of the kidney,MESTK)临床病理特征。方法收集5例MESTK的临床资料及随访结果,采用HE染色及免疫组织化学染色,观察组织学特征及免疫组织化学特点,并复习相关文献。结果5例均为女性,年龄44~62岁,平均51.2岁。临床表现主要为腰背部疼痛及血尿,影像学检查提示肾脏囊实性占位。病理大体表现为肾脏界线清楚的囊实性肿瘤,多位于肾中极;组织学特征:肿瘤由上皮和间质成分混合构成,上皮排列成小管、微囊、大囊、乳头等结构,间质由梭形细胞组成,疏密不一,可见卵巢样间质、间质水肿及慢性炎症细胞浸润,上皮及间质细胞均未见明显异型性。免疫组织化学:上皮细胞表达广谱细胞角蛋白(CK_(pan))、CK7、PAX-8、P504S,间质细胞大多表达结蛋白(desmin)、平滑肌肌动蛋白(SMA)、雌激素受体(ER)、孕激素受体(PR)、CD10,Ki-67增殖指数低。结论MESTK是一种罕见的良性肾脏肿瘤,好发于围绝经期女性,影像学检查常误诊为囊性肾癌,有独特的病理组织学和免疫组织化学表现,肿物完整切除后,预后良好。
