ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
目的 分析6例胰腺实性假乳头状瘤病例，探讨其诊断、治疗方法。方法 对我院2005年1月至2008年6月期间收治的6例胰腺实性假乳头状瘤病例的临床资料进行回顾性分析。结果 6例患者年龄15～42岁，平均26.7岁； 其中男1例，女5例。 肿瘤位于胰头2例，胰体尾部4例。 无特异性临床表现。 血清肿瘤标志物均为阴性。 2 例行胰十二指肠切除术，4例行胰体尾及脾切除术。6例患者均获随访，随访时间6～48个月，平均24个月，均未发现肿瘤复发、转移。 结论 胰腺实性假乳头状瘤是一种罕见的低度恶性胰腺肿瘤，多发于青年女性； 术前、术中明确诊断有助于术式的选择，提高患者的生存质量。
Objective To investigate differential points of clinical symptoms and pathology of solid-pseudopapillary tumor of the pancreas (SPTP) and islet cell tumor (ICT). Methods Fifteen cases of SPTP and twelve cases of ICT were studied in this retrospective research. Clinical symptom, pathologic feature and computed tomography (CT) image of patients with both tumors were analyzed, and the imaging features were compared with pathological results. Results The mean age of SPTP patients was 22.4 year-old. Twelve patients with SPTP presented a palpable abdominal mass as the initial symptom. It was observed that the tumor cells were located in a pseudopapillary pattern with a fibro-vascular core histologically. On the CT images, a mixture of solid and cystic structures could be seen in all the tumors. After taking enhanced CT scan, the solid portion was slightly enhanced in the arterial phase and the contrast intensity increased in the portal venous phase. On the other hand, the mean age of ICT patients was 39.3 year-old. The major symptom was due to the function of islet cell tumor, which was typical in 8 patients, presenting as Whipple triad. Histologically, cells demonstrated in trabecular, massive, acinar or solid patterns, and the blood supply of the tumor was abundant. On the CT images, most small tumors were difficulty to be detected. ICT could be markedly enhanced in the arterial phase and slightly enhanced in the portal venous phase on post-contrast CT scan. Conclusion Clinical symptom, pathologic feature and CT scanning are helpful to differentiate SPTP from ICT.
Objective To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas. Methods Demographic data, clinical manifestations, diagnostic exams, surgical procedures, pathological diagnosis, postoperative complications, and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively. Results There were 8 （28%） serous cystic tumors （SCN）, 12 （41%） mucinous cystic tumors （MCN）, 3 （10%） intraductal papillary mucinous tumors （IPMN）, and 6 （21%） solid pseudopapillary tumors （SPT）. Eight cases of SCN, 7 cases of MCN, 1 case of IPMN, and 5 cases of SPT were all benign. The ages of the patients were from 15 to 78 years〔average, （49±17）years〕and all tumors were more common in female （76%, 22/29）. Twenty-three cases of 29 patients were performed operations, 22 cases were underwent surgical resection, and 1 case was performed exploration and biopsy. There was no surgery-related death. The rest 6 cases were not performed operation. Twenty-one cases followed-up for 6 months to 8 years 〔average, （2.7±2.3） years〕, 8 cases didn’t followed-up. Sixteen cases with surgical resection had no recurrence during follow-up period, 1 case performed exploration and biopsy died in 1 year after operation, and 4 cases of SCN without surgery didn’t deteriorate. Conclusions The most common cystic neoplasms of pancreas are mucinous and serous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 42% of mucinous cysts are malignant. Misdiagnosis may delay appropriate treatment and increase mortality. The resection rate of pancreatic cystic tumor is high, and the prognosis is good after radical resection.
ObjectiveTo detect human papilloma virus (HPV)infection with fluorescent quantitative real-time polymerase chain reaction (FQ-PCR)in Minnan population, and explore the correlation between HPV infection and carcinogenesis of esophageal carcinoma (EC)of Minnan patients. MethodsFQ-PCR was performed to examine HPV-6, HPV-11, HPV-16 and HPV-18 in 100 healthy Minnan people (healthy group, 66 males and 34 females with their age of 52.35±6.72 years)and 100 Minnan patients with squamous EC (EC group and tumor-adjacent normal tissue group, 64 males and 36 females with their age of 51.62±6.37 years)between October 2009 and December 2012. ResultsThe incidences of HPV infection in 100 EC tissues, 100 tumor-adjacent normal tissues and 100 esophageal mucosa tissues of healthy people were 22/100, 8/100 and 6/100 respectively, which were statistically different (χ2=10.63, P < 0.01). Positive infection of HPV-6, HPV-11, HPV-16 and HPV-18 was observed in 11 cases, 11 cases, 14 cases and 15 cases in EC group respectively, 5 cases, 6 cases, 7 cases and 8 cases in tumor-adjacent normal tissue group respectively, and 5 cases, 5 cases, 6 cases and 6 cases in the healthy group respectively (P > 0.05). Positive HPV infection was observed in 1 patients with well differentiated squamous EC, 21 patients with moderately differentiated squamous EC and 5 patients with poorly differentiated squamous EC (P > 0.05). ConclusionHPV infection may exist in tumor tissue of Minnan patients with squamous EC, and may be correlated with carcinogenesis and development of squamous EC.
Objective To analyze characteristics of solid pseudopapillary neoplasm (SPN) of pancreas and to discuss it’s diagnosis and treatment. Methods The clinicopathologic data of 39 patients with pathologically diagnosed as SPN from January 2012 to July 2017 in the First Affiliated Hospital to Xinjiang Medical University were collected, the clinical characteristics, imaging features, diagnosis and treatment methods, and prognosis were analyzed. Results Among the 39 patients, there were 27 benign SPNs and 12 malignant SPNs. There were no significant differences in the gender, age, blood type, clinical manifestations, distribution of tumor sites, morphological features, and proportions of combined calcification, intracapsular hemorrhage, and pancreatic ductal dilatation between the benign and malignant SPN patients (P>0.050). The maximum diameter of the tumor, the integrity of the capsule, and the ratio of the tumor cystic solidity had significant differences (P<0.050) between the benign and malignant SPN patients. That was, in patients with benign SPN, the largest tumor diameter was less than or equal to 5 cm, and the capsule was complete, and the tumor was mainly cystic and solid. Of the 27 patients with benign SPN, 6 underwent the tumor enucleation, 7 underwent the standard pancreatoduodenectomy, 2 underwent the middle pancreas resection, 5 underwent the standard caudal pancreatectomy, and 7 underwent the spleen-preserving caudal pancreatectomy. Of the 12 patients with malignant SPN, 8 underwent the standard pancreatoduodenectomy and 4 underwent the standard caudal pancreatectomy. All the patients were discharged after surgery and no intra-abdominal infection occurred. The pancreatic leakage occurred in 4 patients and recoved after the full drainage. The average follow-up was 24.5 months, no patient had the tumor metastasis or recurrence, and no patient died. Conclusions Incomplete capsule and the largest diameter >5 cm may suggest malignancy of SPN, and near-solid tumors may be indicative of benignancy. Surgery is a crucial and most effective treatment for SPN, and it is suggested that routine radical operation is performed for malignant SPN.
Objective To summarize the current diagnostic and therapeutic advancement of solid pseudopapillary tumor of the pancreas. Methods Relevant literatures about the diagnosis and treatment of solid pseudopapillary tumor of the pancreas, which were published recently domestic and abroad were collected and reviewed. Results Solid pseudopapillary tumor of the pancreas is now considered to be a low-grade malignancy with characteristic clinical, imaging and pathological features. Resection is considered to be the optimal choice with favourable prognosis. Conclusion An awareness of the features may guide us to a correct diagnosis and treatment of this rare neoplasm, but the deep understanding of the disease needs the accumulation of more cases and fundamental research.
To analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP), and correlation with the pathological findings of the disease so as to improve the diagnostic abilities, the CT images and the clinical manifestations, we retrospectively analyzed the pathological materials of 23 cases with surgery and pathology proved SPTP. In the 23 patients, 21 cases were female (91.3%) and 2 were male (8.7%). The most common symptom was abdominal discomfort with dull pain in 12 patients (52.2%). Others included the pancreatic mass that was detected incidentally during physical examination in 9 patients (39.1%), nausea/vomiting in 2 patients (8.7%). And 1 case of female patients had 2 lesions. In the 24 tumors, 6 cases were located at the head (25.0%), 3 were at neck (12.5%), 8 cases were at body (33.3%), and 7 cases were at tail of pancreas respectively (29.2%). The long-axis diameter ranged from 2.1cm to 20.1cm (mean 6.4cm). 9 tumors were mostly solid component (37.5%), 10 tumors were contained similar proportion of solid and cystic part (41.7%), and mainly cystic components in 5 tumors (20.8%). In 9 of the 23 patients, calcification was found in the tumor (39.1%). In 2 of the 23 patients, bleeding was seen in the mass (8.7%). The dilation of intrahepatic bile duct was found in 1 patient (8.7%). Liver metastasis was showed in one patient (8.7%). On post-contrast CT scan, solid parts demonstrated mild enhancement at the arterial phase. At the portal phase, solid parts were enhanced continuously in all cases, and the enhancement degrees were lower than normal pancreatic tissue. The cystic parts of all lesions showed no enhancement. Pseudo papillary structure, hemorrhage, necrosis, or cystic degeneration were found in all patients by histological study. In a word, SPTP has comparatively characteristic CT imaging features consistent with histological features, when combined with clinical manifestations, could be correctly diagnosed and differentially diagnosed.