胰腺内分泌肿瘤与腺泡细胞癌的病理诊断及鉴别诊断

摘要

Objective:To explore the clinicopathologic fealures and differential diagnosis of pancrealic endocrine Lumor ( PET). Methods:The clinicopalhologic and immunohislochemical fealures of 3 PET were analysed. Combined with the literatures, the diagnosis of pancrealic acinar cell carcinoma were idenlified. Results:The PET cells were solid flake and trabecular shape, acinar-like arrangement and not significant cellular alypia,and rich blood vessels in intercellular substance. Chromogranin A,synaplophysin,and the endocrine markers of insulin were detected by immunohistochemistry. Conclusions:Most PET are benign,but the pancreatic acinar cell carcinoma is highly invasive tumor. The morphology of the pancreatic acinar cell carcinoma is similar to the PET, and the biological behaviors of two types tumor have significantly different, and distinguishing two types of famor has obvious clinical significance.%目的:探讨胰腺内分泌肿瘤(PET)的临床病理学特征及其与腺泡细胞癌的鉴别诊断.方法:对3例PET进行临床病理和免疫组织化学分析,结合文献讨论其与胰腺腺泡细胞癌的鉴别.结果:PET组织学上肿瘤细胞呈实性片状、小梁状、腺泡状排列,结构上与腺泡细胞癌相似,但细胞无明显异型,间质中血管丰富.免疫组织化学表达嗜铬素A、突触素、胰岛素内分泌标志.结论:PET大多数为良性肿瘤,而胰腺腺泡细胞癌属于高度侵袭性肿瘤,二者形态上相似,但生物学行为却明显不同,因此区分两类肿瘤有明显的临床意义.