Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients
Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients
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DOI：
10.1046/j.1440-1827.2001.01258.x
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发表时间：
2001-09-01
影响因子：
2.2
通讯作者：
Manabe, T
中科院分区：
文献类型：
--
作者：
Nakamura, E;Shimizu, M;Manabe, T
为探讨胰腺继发性肿瘤的临床病理特点，我们回顾了10年来690例胰腺恶性肿瘤(不包括原发胰腺癌)中103例胰腺继发性肿瘤的尸检资料和病理特点。这项研究中有67名男性和36名女性，年龄从2岁到94岁不等(平均61岁)。在恶性肿瘤尸检病例中，胰腺继发肿瘤的发生率为15%，其中大部分继发肿瘤为癌。胃是最常见的原发肿瘤部位(20%)，其次是肺(18%)和肝外胆管(13%)。由于每个原发癌的总数不同，我们特别关注每个原发癌中胰腺转移的发生率。我们发现，在每种类型的原发癌中，Vater乳头癌的胰腺转移率最高(75%)。大约一半的转移灶是孤立的，但34例(33%)肉眼看不到胰腺转移灶。组织学上最常见的癌是腺癌，其次是大细胞癌、小细胞癌和神经内分泌癌。最常见的非上皮性肿瘤是白血病，其次是恶性淋巴瘤。未分化癌和神经内分泌癌多见于肝外胆管或膀胱癌合并胰腺转移。73%的肿瘤细胞在镜下表现为小叶间和小叶内的浸润型。脂肪坏死是最常见的相关病理发现(19%)。我们的研究表明，在大约六七分之一的恶性肿瘤尸检病例中，可以发现胰腺继发性肿瘤，在日本，最常见的是胃腺癌。
To investigate the clinicopathological features of patients with secondary tumors of the pancreas, we reviewed autopsy records and pathological features of 103 cases with pancreatic secondary tumors from 690 cases of malignant tumors (excluding cases of primary pancreatic cancer) over a 10-year period. There were 67 men and 36 women in the study, ranging in age from 2 to 94 years (mean: 61 years). The incidence of pancreatic secondary tumors was 15% in the autopsy cases of malignant tumors, and the majority of the secondary tumors were carcinomas. The stomach was the most common primary tumor site (20%), followed by the lung (18%) and extrahepatic bile duct (13%). Because the total number of each primary carcinoma differed, we paid specific attention to the incidence of pancreatic metastasis in each primary carcinoma. We found that carcinoma of the papilla of Vater showed the highest rate of incidence (75%) of pancreatic metastasis in each type of primary carcinoma. Approximately half of the metastatic lesions were solitary, but the metastatic lesions in the pancreas could not be identified macroscopically in 34 cases (33%). Histologically, the most common carcinoma was adenocarcinoma, followed by large cell carcinoma, small cell carcinoma and neuroendocrine carcinoma. The most common non-epithelial tumor was leukemia, followed by malignant lymphoma. Undifferentiated carcinoma and neuroendocrine carcinoma were often found in cases of extrahepatic bile duct or urinary bladder carcinoma with pancreatic metastasis. As for the microscopic infiltration patterns of tumor cells, 73% of cases showed an interlobular and intralobular infiltration. Fat necrosis was most frequently seen as an associated pathological finding (19%). Our study indicates that secondary tumors of the pancreas can be found in approximately one out of six to seven autopsy cases of malignant tumors, and in Japan, the most common of these is adenocarcinoma of the stomach.