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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2017, Vol. 14 ›› Issue (06) : 428 -432. doi: 10.3877/cma.j.issn.1672-6448.2017.06.007

所属专题： 文献；

腹部超声影像学

胰腺腺泡细胞癌的临床及超声影像特征
谭莉1, 吕珂1,†(), 仲光熙1, 张璟1, 张青1, 孝梦甦1, 桂阳1, 周桂丽2, 姜玉新1   
  1. 1. 100730　中国医学科学院　北京协和医学院　北京协和医院超声医学科
    2. 100730　中国医学科学院　北京协和医学院　北京协和医院超声医学科；518112　深圳市孙逸仙心血管医院超声科
  • 收稿日期:2017-01-11 出版日期:2017-06-01
  • 通信作者: 吕珂
  • 基金资助:
    国家卫生和计划生育委员会公益性行业科研专项项目(201402001); 中国医学科学院医学与健康科技创新工程经费资助（消化道肿瘤）(2016-I2M-3-005)

Clinical and ultrasound imaging features of pancreatic acinar cell carcinoma

Li Tan1, Ke Lyu1,†(), Guangxi Zhong1, Jing Zhang1, Qing Zhang1, Mengsu Xiao1, Yang Gui1, Guili Zhou2, Yuxin Jiang1   

  1. 1. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
    2. Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; Department of Ultrasound, Shenzhen Sun Yat-sen Cardiovascular Hospital, Shenzhen 518112, China
  • Received:2017-01-11 Published:2017-06-01
  • Corresponding author: Ke Lyu
  • About author:
    Corresponding author: Lyu Ke, Email:
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引用本文：

谭莉, 吕珂, 仲光熙, 张璟, 张青, 孝梦甦, 桂阳, 周桂丽, 姜玉新. 胰腺腺泡细胞癌的临床及超声影像特征[J/OL]. 中华医学超声杂志（电子版）, 2017, 14(06): 428-432.

Li Tan, Ke Lyu, Guangxi Zhong, Jing Zhang, Qing Zhang, Mengsu Xiao, Yang Gui, Guili Zhou, Yuxin Jiang. Clinical and ultrasound imaging features of pancreatic acinar cell carcinoma[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(06): 428-432.

目的

探讨胰腺腺泡细胞癌（PACC）的临床及超声声像图特征。

方法

收集1999年1月至2015年12月在北京协和医院就诊，经病理证实为PACC的患者13例，其中，男性9例，女性4例，年龄30~76岁，平均年龄（53.9±12.4）岁。临床症状包括腹痛、恶心、胸闷、消瘦。对13例PACC患者的临床、超声及超声造影表现进行分析。

结果

13例患者中，5例（38.5%）患者血清肿瘤标志物浓度升高。肿瘤发生于胰腺体尾部8例（61.5%），胰头部4例（30.8%），1例累及全胰（7.7%）。肿瘤最大径2.0~14.4 cm，囊实性结构4例（30.8%），边界清晰者6例（60.0%），呈外凸性生长5例（38.5%），胰胆管扩张3例（23.1%）。肝转移4例（30.8%），淋巴结转移3例（23.1%），累及血管4例（30.8%）。2例行超声造影，1例动脉期等增强，1例高增强。

结论

PACC超声表现多为边界清、外凸、体积较大、血供相对丰富的囊实性肿物，有一定特征性。

关键词: 超声检查, 胰腺肿瘤, 癌，腺泡细胞
Objective

To explore the clinical and sonographic characteristics of pancreatic acinar cell carcinoma (PACC).

Methods

The clinical data and abdominal sonographic findings of 13 cases of PACC identified with pathology were reviewed, including contrast-enhanced ultrasound (CEUS) images. There were 9 males and 4 females with the average of 53.9 years old. Symptoms included upper abdominal pain, nausea, chest distress and weight loss.

Results

The serum level of tumor maker was elevated in only 5 cases. Eight masses (61.5%) were located in the pancreatic body-tail, 4 (30.8%) in the head, the whole pancreas was involved in 1 case. The mean maximal diameter was 8.0 cm. Four lesions (30.8%) presented as solid-cystic mass. Well-defined border was showed in 6 cases (60.0%). Exophytic type was observed in 5 cases (38.5%). Pancreatic ductal dilation was seen in 3 cases (23.1%), in which 2 cases showed obstruction of common biliary duct. Liver metastasis was assessed in 4 patients (30.8%), and lymph node metastasis in 3 cases (23.1%). Vessels were invaded in 4 cases (30.8%). In 2 cases by CEUS, one showed arterial iso-enhancement, the other with strong enhancement.

Conclusion

Certain characteristic clinical and ultrasonographic features could be revealed in PACC, as a sizable, exophytic, solid-cystic and relatively hypervascular mass with well-definded border.

Key words: Ultrasonography, Pancreatic neoplasms, Carcinoma, acinar cell
图1，2 胰腺腺泡细胞癌患者常规超声声像图表现。图1二维声像图示：胰腺体部见8.4 cm×4.1 cm欠均质低回声，形态规则，边界清晰光滑，内见部分不规则无回声区；图2 彩色多普勒超声图像示：病灶内可见丰富动脉血流信号，其后方脾静脉受压变窄，血管壁光滑，未见明显受侵
图3~5 胰腺腺泡细胞癌患者超声造影表现。图3示动脉期（20 s）可见病灶实性区域内丰富而粗大的肿瘤血管，弥漫增强，病灶与周边组织分界清晰；图4示静脉期（71 s）病灶实性部分持续增强，囊性区域始终未见增强；图5示静脉期（172 s）病灶实性部分缓慢廓清，呈低增强
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