目的:回顾性分析胰腺实性假乳头状癌(SPC)的CT表现及病理学特征,提高对该病的认识.方法:搜集经手术证实的11例胰腺实性假乳头状肿癌病例,男3例,女8例,平均年龄37岁,分析其CT表现,并与病理结果作对照分析.结果:肿块平均最大径5.8cm,CT表现为胰腺内密度均匀/不均匀的肿块,5cm以下病灶以实性密度为主,5cm以上病灶以囊实性为主.其中7例位于胰头,2例位于胰体,2例位于胰尾.增强扫描无强化或周边强化.9例包膜显示不完整,3例SPC出现胆总管及肝内胆管扩张,SPC以侵犯邻近血管为主,淋巴结转移少见.镜下:肿瘤有实性区、囊性区及假乳头区,细胞核有轻度异形性及核分裂相,部分可见神经血管侵犯及包膜浸润;免疫组化:SPC高表达β-catenin、α-1-AT、NSE、Vim阳性.结论:胰腺SPC 的CT特征具有相对特异性,与病理所见相一致.%Objective:To retrospectively evaluate the CT features and clinicopathologic characteristics of solid pseudo papillary carcinoma (SPC) of pancreas. Methods:All the 11 cases of SPC were confirmed by surgery and pathology,The pa tients included 3 males and 8 females with mean age of 34. 9 years. The CT features and pathological characteristics were analyzed and compared. Results:The average maximum diameter of SPC was 5. 8cm. The lesions showed either homogeneous density or inhomogeneous density. In 5 cases with diameter≥5cm the lesions showed inhomogeneous cystic solid density. Of all 11 cases,7 lesions were located in the pancreatic head,2 in the body and 2 in the tail. 9 cases showed the encapsulation to be incomplete and 3 cases showed pancreatic duct and bile duct to be dilated. Enhanced solid areas were also present at the periphery of the mass and the invasion mainly involved the surrounding vessels while metastasis by lymph node was rare. Microscopically,the tumor had solid areas,cystic areas and false nipple areas;There were light nuclear pleomorphism and mitotic rate in the tumor cells. By immunohistochemistry,α1 AT,NSE and VIM were positive. Conclusion:SPC has rel atively specific CT and pathological characteristics,CT features and pathological findings were consistent.
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