Spindle cell carcinoma of the pancreas.
Spindle cell carcinoma of the pancreas.
复制标题
胰腺梭形细胞癌。
DOI：
10.1007/s005340050183
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
T. Aikou
中科院分区：
文献类型：
--
作者：
M. Kubo;S. Takao;H. Shinchi;K. Uchikura;M. Higashi;S. Yonezawa;T. Aikou
我们经历了一个罕见的情况下，梭形细胞癌的胰腺。患者为一名74岁男性，主诉腹痛和体重减轻。超音波扫描显示胰脏头部有一直径4公分的低回声实性肿块，并有一高回声斑点，提示中央坏死或出血。肿块在增强CT扫描上呈低密度，血管造影上呈低血供。在剖腹手术时，肿瘤已侵犯到结肠系膜，但未发现播散及远处转移，因此我们施行保留幽门的胰管切除术及升结肠切除术。患者在术后第26天顺利恢复后出院。两个月后，他因腹水再次入院，细胞学显示梭形细胞阳性;他于术后第92天死亡。在切除的标本中，肿瘤有一个主要的肉瘤成分，包括梭形细胞，和一个小的腺体成分。免疫组化，这两种成分的细胞角蛋白和上皮膜抗原阳性，但波形蛋白和结蛋白阴性。肿瘤被诊断为胰腺梭形细胞癌。发现有硬膜外浸润、淋巴管浸润及血管浸润，但未发现淋巴结转移，虽行根治性手术，但预后极差。
We experienced a rare case of spindle cell carcinoma of the pancreas. The patient was a 74-year-old man who complained of abdominal pain and loss of weight. Ultrasonographic scans revealed a hypoechoic solid mass in the head of the pancreas, 4 cm in diameter, with a high echoic spot suggestive of central necrosis or hemorrhage. The mass was hypodense on enhanced computed tomographic scans and hypovascular on angiograms. At laparotomy, the tumor had invaded to the mesocolon, but dissemination and distant metastasis were not found. We therefore performed pylorus-preserving pancreatoduodenectomy and ascending colectomy. The patient was discharged on postoperative day 26 after an uneventful recovery. Two months later, he was readmitted because of ascites, with positivity of spindle cells shown on cytology; he died on day 92 after surgery. In the resected specimen, the tumor had a mostly sarcomatous component, consisting of spindle-shaped cells, and a small glandular component. Immunohistochemically, both components were positive for cytokeratin and epithelial membrane antigen, but negative for vimentin and desmin. The tumor was diagnosed as a spindle cell carcinoma of the pancreas. Perinural invasion, lymphatic permeation, and blood vessel invasion were found, but lymph node metastasis was not found. Although a curative operation was performed, the outcome in this patient was very poor.