Clinical Gastroenterology Vol.13 No.11(11)

Theme Digestive Diseases to Know -- Biliary Tract, Pancreas
Title Solid and Cystic Tumor
Publish Date 1998/10
Author Takeyuki Idei Dispensary of First Air Depot, Japan Air Self-Defense Force / First Department of Surgery, National Defense Medical College
[ Summary ] Case 1: A 13-year-old girl was admitted with an abdominal mass, which had been palpated by chance. Ultrasonography and CT revealed a cystic, partially solid mass in the head of pancreas. Performing a laparotomy, the mass was seen to be encapsulated by a thick wall, adhering to the head of the pancreas. The resected mass was 9.0 x 7.5 x 6.5cm in size. Upon dissection, it was seen to be composed of solid, and cystic lesions, including hemorrhagic and necrotic materials. Microscopically, uniform eosinophilic cells, with round to oval nuclei, formed solid sheets or pseudopapillary structures in the solid lesion. PAS-reaction was focal positive : The tumor cells were stained by Grimelius' silver stain. Electron examinations showed secretory granules and neurosecretory granules in the tumor cells ; no abnormality was found in the pre-operative endocrine data (including insulin, gastrin and glucagon) in her blood. So we understood it to be a case of solid cystic tumor with endocrine differentiation. Case 2 : A 15-year-old girl was admitted with complaints of abdominal pain. Radiography showed a partially calcificated mass in the tail of the pancreas. No abnormality was found in the pre-operative endocrine data(including insulin, gastrin and glucagon) in her blood. Distal pancreatectomy revealed a solid, cystic mass, 3.4 x 2.7 x 2.7cm in size. Microscopic structures of the tumor resembled those of the Case 1. PAS-reaction was positive. The tumor cells were not stained by Grimelius' silver stain. Electron examinations showed secretory granules and only a few neurosecretory granules in some of the tumor cells. We understood it to be a case of a solid cystic tumor.
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