Sarcomatoid carcinoma of the pancreas: A case report
Sarcomatoid carcinoma of the pancreas: A case report
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胰腺肉瘤样癌：一例报告
DOI：
10.12998/wjcc.v7.i2.236
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发表时间：
2019-01-26
影响因子：
1.1
通讯作者：
Wang, Wei-Lin
中科院分区：
文献类型：
--
作者：
Zhou, Dong-Kai;Gao, Bing-Qiang;Wang, Wei-Lin
背景胰腺肉瘤样癌是一种罕见的侵袭性上皮性肿瘤，兼具上皮性和间叶性。它的特点是肉瘤样成分，并有上皮分化的证据。“肉瘤样癌”一词常与“癌肉瘤”相混淆。他经历了4周的尿液变黑、巩膜黄斑和乏力。计算机断层扫描和磁共振成像显示胰头有肿块，实验室测试显示血清胆红素水平升高。患者在胆道减压后接受了胰十二指肠切除术。组织学上，肿瘤大部分可见梭形细胞，核A型明显，有丝分裂活跃，呈片状或束状排列。免疫组织化学分析发现，梭形细胞对上皮标志物呈强弥漫性阳性，表明上皮分化。结论肉瘤样癌和癌肉瘤虽然具有不同的病理特点，但均起源于上皮样病变。
BACKGROUNDSarcomatoid carcinoma of the pancreas (SCP) is a rare and aggressive epithelial tumor that has both epithelial and mesenchymal features. It is characterized by sarcomatous elements with evidence of epithelial differentiation. And the term "sarcomatoid carcinoma" is often confused with "carcinosarcoma".CASE SUMMARYWe present a case of SCP with lymph node metastasis in a 59-year-old male patient. He had experienced darkening of the urine, scleral icterus, and fatigue for 4 weeks. Computed tomography and magnetic resonance imaging revealed a mass in the pancreatic head, and laboratory tests revealed elevated serum bilirubin levels. The patient underwent pancreaticoduodenectomy after biliary decompression. Histologically, spindle cells with marked nuclear a typia and brisk mitotic activity arranged in a storiform or fascicular pattern were present in the bulk of the tumor. Immunohistochemical analysis found that the spindle cells exhibited strong diffuse positivity for epithelial markers, indicative of epithelial differentiation. Accordingly, the pathologic diagnosis of the pancreatic neoplasm was SCP.CONCLUSIONAlthough sarcomatoid carcinomas and carcinosarcomas have different pathologic features, both have epithelial origin.