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目的总结胰腺实性假乳头状瘤(SPT)的临床特征与诊断经验。方法对2000年2月至2007年3月在中国人民解放军总医院经术后病理证实的24例SPT的临床表现和实验室、影像学、术前及术中病理检查等资料进行回顾性分析。结果女性23例,男性1例,平均年龄24.4岁。首诊临床表现为腹部肿物5例、腹痛7例、腹泻1例、恶心腹胀2例等,9例无任何临床症状。血清肿瘤标记物水平均正常。影像学检查均提示胰腺或腹腔内边界清楚的实性或囊实性占位病变,肿瘤位于胰头部13例,胰体部4例,胰尾7例,核磁共振(MRI)的诊断符合率(40.0%)要高于CT(16.7%)。术前2例行超声引导下肿瘤活组织检查,6例行术中快速冰冻病理检查,分别有1例和3例诊断为SPT。结论SPT的正确诊断依赖于临床表现、影像学特征,尤其是病理学检查的综合分析。
Objective To summarize the clinical features and diagnosis of solid pseudopapillary tumor of pancreas (SPT). Methods The clinical manifestations, laboratory findings, imaging, preoperative and intraoperative pathological findings of 24 SPT patients confirmed by postoperative pathology in Chinese PLA General Hospital from February 2000 to March 2007 were analyzed retrospectively. Results There were 23 females and 1 males, with an average age of 24.4 years. The first clinical manifestations of abdominal mass in 5 cases, abdominal pain in 7 cases, 1 case of diarrhea, nausea and bloating in 2 cases, 9 cases without any clinical symptoms. Serum tumor markers were normal. Radiographic examination showed clear solid or cystic solid lesions in the pancreas or peritoneal border. The tumor was located in the head of the pancreas in 13 cases, 4 cases of pancreatic body and 7 cases of pancreatic tail. The coincidence rate of magnetic resonance imaging (MRI) (40.0%) than CT (16.7%). Tumor biopsies were performed under ultrasound guidance in 2 patients before surgery, and rapid frozen pathology was performed in 6 patients. One patient and 3 patients were diagnosed as SPT respectively. Conclusion The correct diagnosis of SPT depends on the clinical manifestations, imaging features, especially the comprehensive analysis of pathological examination.