目的：分析胰腺实性假乳头状肿瘤（ SPTP）的临床表现、临床病理特征、鉴别诊断及其预后。方法对1例SPTP进行大体、光镜及免疫组织化学检测，并结合文献复习。结果29岁女性患者，因上腹部饱胀不适入院，CT示胰尾部肿物。组织病理学检查示，肿瘤由被覆数层上皮细胞的假乳头和囊腔形成，瘤细胞呈小圆形，无明显异型性，未见核分裂像，局部见包膜外浸润。免疫组织化学显示肿瘤细胞β-Catenin强阳性，NSE、α-AT、CD10和vimentin均阳性，CgA、CKpan均阴性。随访二年未见复发或转移。结论 SPTP是一种少见的低度恶性肿瘤，易被误诊为良性疾病，诊断依据其临床特征、病理组织学特点及免疫组化结果，手术切除是首选治疗方法，预后良好。%Objective To investigate the clinical manifestation , the clinicopathological features , differential diagnosis and prognosis of solid pseudopapillary tumor of pancreas ( SPTP ) .Methods A case of SPTP was analyzed grossly , light microscopically and immunohistochemically and related literatures were reviewed .Results A 29-year-old female patient was found to have the tumor in pancreatic tail on a chest CT after epigastric unwell .Histopathologically , the tumor were composed of pseudopapillary structure and cystic structure, surrounded by epithelial cells without significant nuclear atypia .Morphology of tumor cells were small circle and more consistent .Mitosis were not observed in tumors .Immunohistochemically , the tumor cells were strongly positive for β-Catenin.Pseudopapillary structure were positive for NSE ,α-AT, CD10 and vimentin.CgA and CKpan were all negative .The patient was followed up for 36 months, and she had no recurrence and metastasis.Conclusions SPTP is a rare low-grade malignancy, easily misdiagnosed as benign disease , Clinical feature, pathological morphology and immunohistochemistry are very important in the diagnosis and differential diagnosis of SPTP .Surgical resection is curative for these patients .The patients have a relatively good prognosis .
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