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Pathological differential diagnosis of solid-pseudopapillary neoplasm and endocrine tumors of the pancreas

Pathological differential diagnosis of solid-pseudopapillary neoplasm and endocrine tumors of the pancreas

作     者:Liu, Bao-An Li, Zhuo-Ming Su, Zhan-San She, Xiao-Ling 

作者机构:Cent S Univ Xiangya Basic Med Sch Dept Pathol Changsha 410013 Hunan Peoples R China Cent S Univ Xiangya Hosp 3 Dept Pathol Changsha 410013 Hunan Peoples R China Cent S Univ Xiangya Hosp 2 Dept Pathol Changsha 410006 Hunan Peoples R China 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2010年第16卷第8期

页      面:1025-1030页

核心收录:

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基  金:Supported by Department of Pathology  Xiangya Basic Medical School  Central-south University 

主  题:Solid-pseudopapillary neoplasm of the pan-creas Pancreatic endocrine tumor Immunohistochem-istry β-catenin gene Differential diagnosis 

摘      要:AIM:To investigate differential points of solid-pseudo-papillary neoplasm (SPN) of the pancreas and pancre-atic endocrine tumor (PET).METHODS:Ten cases of SPN and fourteen cases of PET were studied in this retrospective study. Clinical and pathologic features,immunostaining reactions and β-catenin gene mutations were ***:The mean age of SPN patients was 25.6 years and these patients had no specific symptoms. The mean diameter of the tumors was 11.0 cm,9/10 cases were cystic or a mixture of solid and cystic structures,and there was hemorrhage and necrosis on the cut surface in 8/10 (80%) cases. Characteristic pseudo-papillary structure and discohesive appearance of the neoplastic cells were observed in all 10 (100%) cases. The results of immunostaining showed that nuclear expression of β-catenin and loss of E-cadherin in all the cases,was only seen in SPN. Molecular studies discov-ered that 9/10 (90%) cases harbored a point mutation of exon 3 in β-catenin gene. On the other hand,the mean age of PET patients was 43.1 years. Eight of 14 cases presented with symptoms caused by hypoglyce-mia,and the other 6 cases presented with symptoms similar to those of SPN. The mean size of the tumors was 2.9 cm,most of the tumors were solid,only 3/14 (21%) were a mixture of solid and cystic structures,and macroscopic hemorrhage and necrosis were much less common (3/14,21%). Histologically,tumor cells were arranged in trabecular,acinar or solid patterns and demonstrated no pseudopapillary structure and discohesive appearance in all 14 (100%) cases. The results of immunostaining and mutation detection were completely different with SPN that membrane and cytoplastic expression of β-catenin without loss of E-cadherin,as well as no mutation in β-catenin gene in all the cases. CONCLUSION:Both macroscopic and microscopic features of SPN are quite characteristic. It is not difficult to distinguish it from PET. If necessary,immunos-taining of β-catenin and E-cadherin is quite he

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