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Invasive ductal carcinoma of the pancreas showing exophytic growth

Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 97-102页

作者： Yuichi Sanada Kazuhiro Yoshida Masaoki Itoh Riki Okita morihito okada Department of Surgical Oncology Research Institution for Radiation Biology and MedicineHiroshima University

BACKGROUND:Invasive pancreatic carcinoma generally appears as poorly defined mass reflecting the infiltrative *** aimed to identify the histological and immunohistochemical features in a rare case of pancreatic carcinoma showing exophytic growth. METHODS:A 67-year-old woman presented with a mass of 5.0 cm in diameter in the pancreatic *** computed tomography revealed a well-demarcated, primarily solid mass with a central low-density area. Magnetic resonance cholangiopancreatography revealed neither encasement nor dilation of the main pancreatic *** incorrect preoperative diagnosis was made of solid pseudopapillary tumor of the *** serum carcinoembryonic antigen(CEA)levels and abnormal FDG positron emmission tomography accumulation suggested that the tumor had malignant potential requiring a pancreatoduodenectomy. RESULTS:The head of the pancreas contained a well- circumscribed encapsulated mass of 5.0 cm in diameter, comprising 50%adenocarcinoma,with mucinous carci- noma in the center and anaplastic carcinoma at the *** anaplastic carcinoma comprised pleo- morphic cells(PCs)and pleomorphic giant cells(PGCs). The PGCs phagocytozed mononuclear PCs and lymphocytes adjacent to the capsule without infiltrating the capsule *** revealed that the anaplastic carcinoma cells including PGCs were positive for the tumor antigen Mucin 1 and CEA but negative for vimentin. CONCLUSION:Our observations suggest anaplastic carcinoma components in the present tumor have a ductal origin and that the exophytic tumor growth is associated with the phagocytotic activity of PGCs.

关键词： pancreatic carcinoma anaplastic carcinoma mucinous carcinoma Mucin 1 carcinoembryonic antigen

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