| 摘要: |
| ［摘要］ 目的 分析不典型胰腺实性假乳头状瘤的影像学表现并与病理对照,探讨其诊断价值，就类似影像学表现的疾病进行鉴别诊断。方法 选取77例胰腺实性假乳头状瘤患者，均行手术治疗，并经病理学和免疫组化分析。术前诊断为胰腺实性假乳头状瘤47例,胰腺囊肿7例，假性囊肿4例，胰腺脓肿5例，胰腺浆液性囊腺瘤7例，胰腺癌5例，胰腺血肿2例。对77例患者临床资料进行回顾性分析，比较其影像和病理学特点。结果 77例患者中男性29例，女性48例，年龄2～79岁，平均41.5岁。18例因触及上腹部包块就诊,12例有腹胀,47例无症状。查体：影像学检查发现胰腺或胰周占位性病变,44例为囊实性肿块，16例为单个囊性肿块，10例为实性肿块，7例为多个囊性肿块（囊<3个）。肿瘤位于胰腺头部29个，体部25个，尾部17个，难以确定的部位6个（以胰尾部周围为主）。有或无完整包膜,不伴有胆总管和胰管扩张。病理特点为肿瘤实性部分由实性区、假乳头区及两者过渡区以不同比例混合而成。囊性区由坏死、液化组织及陈旧性出血组成。结论 胰腺实性假乳头状瘤典型影像学表现为较大囊实性肿块，诊断比较容易，但对于表现为单个或多个囊性或单纯实性者，诊断需与有类似表现的胰腺其他疾病鉴别，特别对于老年患者需要与胰腺癌进行鉴别。影像学表现和病理学有一定特征,有助于诊断。 |
| 关键词: 不典型胰腺实性假乳头状瘤 病理 鉴别诊断 |
| DOI：10.3969/j.issn.1674-3806.2013.09.12 |
| 分类号:R 445 |
| 基金项目: |
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| CT imaging findings,differential diagnosis of atypical solid pseudopapillary tumor of pancreas and pathology correlation |
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YAO Feng-qing
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Department of Imaging, Linyi People′s Hospital, Shandong 276000, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the imaging CT findings of atypical solid pseudopapillary tumor of pancreas and pathology correlation,and to analyze the differential diagnosis of it.Methods Seventy-seven cases of solid pseudopapillary tumor of pancreas all received surgery, and were proved by pathology and immunohistochemistry. Preoperative diagnosis included solid pseudopapillary tumor of pancreas(47 cases), pancreatic cyst(7 cases), pseudocyst(4 cases), pancreatic abscess(5 cases), pancreatic serous cystadenoma(7 cases), pancreatic cancer(5 cases) and pancreatic hematoma(2 cases).The clinical materials of all the 77 cases were retrospectively analyzed and the CT imaging and pathology features of atypical solid pseudopapillary tumor of pancreas were investigated.Results The patients included 29 males and 48 females with mean age of 41.5 years(range 2～79 years). Eighteen cases complained abdominal masses,12 abdominal distention and 47 asymptomatic. CT imaging examination demonstrated occupying lesions in the and around pancreas, 44 lesions were solid cystic masses, 16 single cystic masses, 10 solid masses and 7 polycystic masses(less than 3). Among all the 77 cases, 29 lesions located at pancreatic head, 25 at pancreatic body, 17 at pancreatic tail and 6 lesions were difficult of locating. With or without complete capsule, the common bile duct and pancreatic duct didn′t expand. Pathologically, the tumor were composed of solid and pseudopapillary structures, and cystic parts were liquefaction, necrosis and dated hemorrhage.Conclusion It isn′t difficult of diagnosing solid pseudopapillary tumor of pancreas with typically big solid cystic mass, but when solid pseudopapillary tumor of pancreas with single cystic, polycystic or completely solid masses were diagnosed,they should be differentiated from other pancreatic diseases with similar features, especially with pancreatic cancer in older patients. The CT imaging findings and pathology of solid pseudopapillary tumor of pancreas have certain characteristics,which are helpful in the diagnosis. |
| Key words: Atypical solid pseudopapillary tumor of pancreas(SPTP) Pathology Differential diagnosis |
