BACKGROUND: Solid-pseudopapillary tumor of the pancreas (SPTP) is an uncommon and enigmatic pancreatic neoplasm that occurs mainly in young women. Although more and more cases have been reported in recent years, misdi...BACKGROUND: Solid-pseudopapillary tumor of the pancreas (SPTP) is an uncommon and enigmatic pancreatic neoplasm that occurs mainly in young women. Although more and more cases have been reported in recent years, misdiagnosis and incorrect treatment still frequently take place. This study was designed to stimulate consideration of this tumor. METHODS: We retrospectively reviewed the experience of diagnosis and treatment of 15 patients with SPTP and compared them with 516 patients with pancreatic cancer from January 1997 to March 2007. RESULTS: Most of the SPTP cases were asymptomatic except for one palpable mass. Almost all SPTPs demonstrated a solid structure with hypo- or isoattenuation, cystic structure with hypo-attenuation on precontrast CT scan, and enhancement of solid portions on post-contrast CT scan. By contrast, most cases of pancreatic carcinoma had multiple symptoms and abnormal blood results. The tumors showed hypo-attenuation on both precontrast and post-contrast CT scan, and only a few showed iso-attenuation on post-contrast CT scan. All cases of SPTP in our group were cured by surgical resection, while only 16.86% of patients with pancreatic carcinoma could undergo a radical resection. CONCLUSIONS: Clinical features and CT scans were helpful to differentiate SPTP from pancreatic carcinoma. Radical surgical resection was the most effective and safe method for the treatment of SPTP.展开更多
目的探讨胰腺实性．假乳头瘤（solid-pseudopapillary neoplasm of the pancreas，SPN）的临床病理特点。方法收集四川省医学科学院·四川省人民医院病理科2008年9月至2013年2月诊断的10例SPN患者的临床病理资料，对其临床表现、病...目的探讨胰腺实性．假乳头瘤（solid-pseudopapillary neoplasm of the pancreas，SPN）的临床病理特点。方法收集四川省医学科学院·四川省人民医院病理科2008年9月至2013年2月诊断的10例SPN患者的临床病理资料，对其临床表现、病理形态学、免疫表型特征及预后进行分析，并结合文献进行总结。结果10例患者中男1例、女9例；发病年龄15—55岁，中位年龄24岁。肿瘤发生于胰头2例、胰体尾4例、胰尾4例。3例表现为左上腹部疼痛，2例为腹部出现无痛性包块，1例上腹不适，4例为体检时CT发现胰腺占位就诊。肿瘤最大直径2—22cm，平均7．4cm；切面呈分叶状，均可见淡黄色、黄白或灰白相间的实性区，质地较细，可见明显出血、坏死及囊性变区；组织形态学表现为大小一致且黏附性差的肿瘤细胞成巢状或围绕纤细的血管周围排列呈假乳头样，可见不同程度的出血坏死。免疫表型：10例肿瘤细胞均表达Vimentin、β-catenin、CgA、CD10、α1-抗糜蛋白酶、α1-抗胰蛋白酶；还不同程度的表达pan—CK、Syn和PR；Ki-67均为低表达，阳性率1％～5％。10例患者均行肿块切除术。随访6个月至4年，10例患者均存活无复发。结论SPN为胰腺较少见肿瘤，好发于年轻女性，虽然形态学表现良性肿瘤的特征，但具有低度恶性潜能，最后诊断需靠病理组织学及免疫组化检测。展开更多
Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospecti...Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.展开更多
文摘BACKGROUND: Solid-pseudopapillary tumor of the pancreas (SPTP) is an uncommon and enigmatic pancreatic neoplasm that occurs mainly in young women. Although more and more cases have been reported in recent years, misdiagnosis and incorrect treatment still frequently take place. This study was designed to stimulate consideration of this tumor. METHODS: We retrospectively reviewed the experience of diagnosis and treatment of 15 patients with SPTP and compared them with 516 patients with pancreatic cancer from January 1997 to March 2007. RESULTS: Most of the SPTP cases were asymptomatic except for one palpable mass. Almost all SPTPs demonstrated a solid structure with hypo- or isoattenuation, cystic structure with hypo-attenuation on precontrast CT scan, and enhancement of solid portions on post-contrast CT scan. By contrast, most cases of pancreatic carcinoma had multiple symptoms and abnormal blood results. The tumors showed hypo-attenuation on both precontrast and post-contrast CT scan, and only a few showed iso-attenuation on post-contrast CT scan. All cases of SPTP in our group were cured by surgical resection, while only 16.86% of patients with pancreatic carcinoma could undergo a radical resection. CONCLUSIONS: Clinical features and CT scans were helpful to differentiate SPTP from pancreatic carcinoma. Radical surgical resection was the most effective and safe method for the treatment of SPTP.
文摘目的探讨胰腺实性．假乳头瘤（solid-pseudopapillary neoplasm of the pancreas，SPN）的临床病理特点。方法收集四川省医学科学院·四川省人民医院病理科2008年9月至2013年2月诊断的10例SPN患者的临床病理资料，对其临床表现、病理形态学、免疫表型特征及预后进行分析，并结合文献进行总结。结果10例患者中男1例、女9例；发病年龄15—55岁，中位年龄24岁。肿瘤发生于胰头2例、胰体尾4例、胰尾4例。3例表现为左上腹部疼痛，2例为腹部出现无痛性包块，1例上腹不适，4例为体检时CT发现胰腺占位就诊。肿瘤最大直径2—22cm，平均7．4cm；切面呈分叶状，均可见淡黄色、黄白或灰白相间的实性区，质地较细，可见明显出血、坏死及囊性变区；组织形态学表现为大小一致且黏附性差的肿瘤细胞成巢状或围绕纤细的血管周围排列呈假乳头样，可见不同程度的出血坏死。免疫表型：10例肿瘤细胞均表达Vimentin、β-catenin、CgA、CD10、α1-抗糜蛋白酶、α1-抗胰蛋白酶；还不同程度的表达pan—CK、Syn和PR；Ki-67均为低表达，阳性率1％～5％。10例患者均行肿块切除术。随访6个月至4年，10例患者均存活无复发。结论SPN为胰腺较少见肿瘤，好发于年轻女性，虽然形态学表现良性肿瘤的特征，但具有低度恶性潜能，最后诊断需靠病理组织学及免疫组化检测。
文摘Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.
