EUS-FNAが診断に有用であった成人膵芽腫の一例
「要旨」:症例は30代女性. 上腹部痛を主訴に当院を受診. CT上, 膵頭部に37mmの境界明瞭な充実性腫瘤を認め, 内部は不均一でわずかに造影され, 石灰化を有していた. EUS-FNAを施行し, 膵芽腫と診断された. 成人の膵芽腫はまれであるが, 悪性度が高く, 迅速なEUS-FNA診断が必須と考えられた. 「はじめに」成人膵芽腫は, 膵腫瘍全体の0.5%とまれな組織型である. 今回, その画像所見, 臨床病理学的特徴および迅速なEUS-FNA診断の重要性について文献的に考察した. なお, 本例は海外も含めた既存報告において, 膵芽腫に対してEUS, 造影EUS, EUS-FNA, Dif...
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| Published in | 膵臓 Vol. 30; no. 5; pp. 689 - 696 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本膵臓学会
25.10.2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0913-0071 1881-2805 |
| DOI | 10.2958/suizo.30.689 |
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| Abstract | 「要旨」:症例は30代女性. 上腹部痛を主訴に当院を受診. CT上, 膵頭部に37mmの境界明瞭な充実性腫瘤を認め, 内部は不均一でわずかに造影され, 石灰化を有していた. EUS-FNAを施行し, 膵芽腫と診断された. 成人の膵芽腫はまれであるが, 悪性度が高く, 迅速なEUS-FNA診断が必須と考えられた. 「はじめに」成人膵芽腫は, 膵腫瘍全体の0.5%とまれな組織型である. 今回, その画像所見, 臨床病理学的特徴および迅速なEUS-FNA診断の重要性について文献的に考察した. なお, 本例は海外も含めた既存報告において, 膵芽腫に対してEUS, 造影EUS, EUS-FNA, Diffusion MRI, MRCPを施行したはじめての症例となる. 「症例」患者:30代女性. 主訴:上腹部痛. 既往歴:特記事項なし. 家族歴:特記事項なし. 現病歴:8カ月前より上腹部痛を自覚し, 他院を受診するが異常なしといわれ, プロトンポンプインヒビターなどを処方されるも改善なく, 当院を受診. |
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| AbstractList | 「要旨」:症例は30代女性. 上腹部痛を主訴に当院を受診. CT上, 膵頭部に37mmの境界明瞭な充実性腫瘤を認め, 内部は不均一でわずかに造影され, 石灰化を有していた. EUS-FNAを施行し, 膵芽腫と診断された. 成人の膵芽腫はまれであるが, 悪性度が高く, 迅速なEUS-FNA診断が必須と考えられた. 「はじめに」成人膵芽腫は, 膵腫瘍全体の0.5%とまれな組織型である. 今回, その画像所見, 臨床病理学的特徴および迅速なEUS-FNA診断の重要性について文献的に考察した. なお, 本例は海外も含めた既存報告において, 膵芽腫に対してEUS, 造影EUS, EUS-FNA, Diffusion MRI, MRCPを施行したはじめての症例となる. 「症例」患者:30代女性. 主訴:上腹部痛. 既往歴:特記事項なし. 家族歴:特記事項なし. 現病歴:8カ月前より上腹部痛を自覚し, 他院を受診するが異常なしといわれ, プロトンポンプインヒビターなどを処方されるも改善なく, 当院を受診. 症例は30代女性．上腹部痛を主訴に当院を受診．CT上，膵頭部に37mmの境界明瞭な充実性腫瘤を認め，内部は不均一でわずかに造影され，石灰化を有していた．EUS-FNAを施行し，膵芽腫と診断された．成人の膵芽腫はまれであるが，悪性度が高く，迅速なEUS-FNA診断が必須と考えられた． |
| Author | 福村, 由紀 椎名, 秀一朗 渡辺, 純夫 加藤, 俊介 川崎, 誠治 金澤, 亮 三浦, 寛子 崔, 仁煥 |
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| DOI | 10.2958/suizo.30.689 |
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| References | 27) Krishna SG, Li F, Bhattacharya A, et al. Differentiation of pancreatic ductal adenocarcinoma from other neoplastic solid pancreatic lesion: a tertiary oncology center experience. Gastrointest Endosc 2015; 81: 370-9. 3) Du E, Katz M, Weidner N, Yoder S, Moosa AR, Shabaik A. Ampullary pancreatoblastoma in an elderly patient: a case report and review of the literature. Arch Pathol Lab Med 2003; 127: 1501-5. 17) Mumme T, Büttner R, Peiper C, Schumpelick V. [Pancreatoblastoma: a rare malignant neoplasm in early adulthood]. Chirurg 2001; 72: 806-11. 11) Cavallini A, Falconi M, Bortesi L, Crippa S, Barugola G, Butturini G. Pancreatoblastoma in adults: a review of the literature. Pancreatology 2009; 9: 73-80. 20) Zhu LC, Sidhu GS, Cassai ND, Yang GC. Fine-needle aspiration cytology of pancreatoblastoma in a young woman: report of a case and review of the literature. Diagn Cytopathol 2005; 33: 258-62. 21) Rajpal S, Warren RS, Alexander M, et al. Pancreatoblastoma in an adult: case report and review of the literature. J Gastrointest Surg 2006; 10: 829-36. 19) Abraham SC, Wu TT, Klimstra DS, et al. Distinctive molecular genetic alterations in sporadic and familial adenomatous polyposis-associated pancreatoblastomas: frequent alterations in the APC/beta-catenin pathway and chromosome 11p. Am J Pathol 2001; 159: 1619-27. 8) Ohike N, Yamochi T, Shiokawa A, et al. A peculiar variant of pancreatoblastoma in an adult. Pancreas 2008; 36: 320-2. 15) Robin E, Terris B, Valverde A, et al. Pancreatoblastoma in adults. Gastroenterol Clin Biol 1997; 21: 880-3. 25) Balasundaram C, Luthra M, Chavalitdhamrong D, Chow J, Khan H, Endres PJ. Pancreatoblastoma: a rare tumor still evolving in clinical presentation and histology. JOP 2012; 13: 301-3. 10) Sheng L, Weixia Z, Longhai Y, Jinming Y. Clinical and biologic analysis of pancreatoblastoma. Pancreas 2005; 30: 87-90. 18) Benoist S, Penna C, Julié C, Malafosse R, Rougier P, Nordlinger B. Prolonged survival after resection of pancreatoblastoma and synchronous liver metastases in an adult. Hepatogastroenterology 2001; 48: 1340-2. 4) Klimstra DS, Wenig BM, Adair CF, Heffess CS. Pancreatoblastoma. A clinicopathologic study and review of the literature. Am J Surg Pathol 1995; 19: 1371-89. 23) Savastano S, d'Amore ES, Zuccarotto D, Banzato O, Beghetto M, Famengo B. Pancreatoblastoma in an adult patient. A case report. JOP 2009; 10: 192-5. 7) Palosaari D, Clayton F, Seaman J. Pancreatoblastoma in an adult. Arch Pathol Lab Med 1986; 110: 650-2. 22) Charlton-Ouw KM, Kaiser CL, Tong GX, Allendorf JD, Chabot JA. Revisiting metastatic adult pancreatoblastoma. A case and review of the literature. JOP 2008; 9: 733-8. 1) Hruban RH, Pitman MB, Klimstra DS. Pancreatoblastoma. In: Tumors of the Pancreas. AFIP Atlas of Tumor Pathology Series 4, Fascicle 6. Washington DC: American Registry of Pathology, 2007: 219-29. 12) Hoorens A, Gebhard F, Kraft K, Lemoine NR, Klöppel G. Pancreatoblastoma in an adult: its separation from acinar cell carcinoma. Virchows Arch 1994; 424: 485-90. 9) Pitman MB, Faquin WC. The fine-needle aspiration biopsy cytology of pancreatoblastoma. Diagn Cytopathol 2004; 31: 402-6. 5) Gruppioni F, Casadei R, Fusco F, Calculli L, Marrano D, Gavelli G. Adult pancreatoblastoma. A case report. Radiol Med 2002; 103: 119-22. 16) Hayasaki N, Miyake N, Takahashi H, et al. [A case of pancreatoblastoma in an adult]. Nihon Shokakibyo Gakkai Zasshi 1999; 96: 558-63. 2) Montemarano H, Lonergan GJ, Bulas DI, Selby DM. Pancreatoblastoma: imaging findings in 10 patients and review of the literature. Radiology 2000; 214: 476-82. 26) Kohda E, Iseki M, Ikawa H, et al. Pancreatoblastoma. Three original cases and review of the literature. Acta Radiol 2000; 41: 334-7. 24) Boix E, Yuste A, Meana A, et al. Corticotrophin-releasing hormone-secreting pancreatoblastoma in an adult patient. Pancreas 2010; 39: 938-9. 13) Dunn JL, Longnecker DS. Pancreatoblastoma in an older adult. Arch Pathol Lab Med 1995; 119: 547-51. 14) Levey JM, Banner BF. Adult pancreatoblastoma: a case report and review of the literature. Am J Gastroenterol 1996; 91: 1841-4. 6) Rosebrook JL, Glickman JN, Mortele KJ. Pancreatoblastoma in an adult woman: sonography, CT, and dynamic gadolinium-enhanced MRI features. Am J Roentgenol 2005; 184 (3 Suppl): S78-81. |
| References_xml | – reference: 22) Charlton-Ouw KM, Kaiser CL, Tong GX, Allendorf JD, Chabot JA. Revisiting metastatic adult pancreatoblastoma. A case and review of the literature. JOP 2008; 9: 733-8. – reference: 6) Rosebrook JL, Glickman JN, Mortele KJ. Pancreatoblastoma in an adult woman: sonography, CT, and dynamic gadolinium-enhanced MRI features. Am J Roentgenol 2005; 184 (3 Suppl): S78-81. – reference: 21) Rajpal S, Warren RS, Alexander M, et al. Pancreatoblastoma in an adult: case report and review of the literature. J Gastrointest Surg 2006; 10: 829-36. – reference: 9) Pitman MB, Faquin WC. The fine-needle aspiration biopsy cytology of pancreatoblastoma. Diagn Cytopathol 2004; 31: 402-6. – reference: 17) Mumme T, Büttner R, Peiper C, Schumpelick V. [Pancreatoblastoma: a rare malignant neoplasm in early adulthood]. Chirurg 2001; 72: 806-11. – reference: 10) Sheng L, Weixia Z, Longhai Y, Jinming Y. Clinical and biologic analysis of pancreatoblastoma. Pancreas 2005; 30: 87-90. – reference: 1) Hruban RH, Pitman MB, Klimstra DS. Pancreatoblastoma. In: Tumors of the Pancreas. AFIP Atlas of Tumor Pathology Series 4, Fascicle 6. Washington DC: American Registry of Pathology, 2007: 219-29. – reference: 27) Krishna SG, Li F, Bhattacharya A, et al. Differentiation of pancreatic ductal adenocarcinoma from other neoplastic solid pancreatic lesion: a tertiary oncology center experience. Gastrointest Endosc 2015; 81: 370-9. – reference: 7) Palosaari D, Clayton F, Seaman J. Pancreatoblastoma in an adult. Arch Pathol Lab Med 1986; 110: 650-2. – reference: 5) Gruppioni F, Casadei R, Fusco F, Calculli L, Marrano D, Gavelli G. Adult pancreatoblastoma. A case report. Radiol Med 2002; 103: 119-22. – reference: 18) Benoist S, Penna C, Julié C, Malafosse R, Rougier P, Nordlinger B. Prolonged survival after resection of pancreatoblastoma and synchronous liver metastases in an adult. Hepatogastroenterology 2001; 48: 1340-2. – reference: 23) Savastano S, d'Amore ES, Zuccarotto D, Banzato O, Beghetto M, Famengo B. Pancreatoblastoma in an adult patient. A case report. JOP 2009; 10: 192-5. – reference: 8) Ohike N, Yamochi T, Shiokawa A, et al. A peculiar variant of pancreatoblastoma in an adult. Pancreas 2008; 36: 320-2. – reference: 24) Boix E, Yuste A, Meana A, et al. Corticotrophin-releasing hormone-secreting pancreatoblastoma in an adult patient. Pancreas 2010; 39: 938-9. – reference: 26) Kohda E, Iseki M, Ikawa H, et al. Pancreatoblastoma. Three original cases and review of the literature. Acta Radiol 2000; 41: 334-7. – reference: 16) Hayasaki N, Miyake N, Takahashi H, et al. [A case of pancreatoblastoma in an adult]. Nihon Shokakibyo Gakkai Zasshi 1999; 96: 558-63. – reference: 12) Hoorens A, Gebhard F, Kraft K, Lemoine NR, Klöppel G. Pancreatoblastoma in an adult: its separation from acinar cell carcinoma. Virchows Arch 1994; 424: 485-90. – reference: 2) Montemarano H, Lonergan GJ, Bulas DI, Selby DM. Pancreatoblastoma: imaging findings in 10 patients and review of the literature. Radiology 2000; 214: 476-82. – reference: 19) Abraham SC, Wu TT, Klimstra DS, et al. Distinctive molecular genetic alterations in sporadic and familial adenomatous polyposis-associated pancreatoblastomas: frequent alterations in the APC/beta-catenin pathway and chromosome 11p. Am J Pathol 2001; 159: 1619-27. – reference: 13) Dunn JL, Longnecker DS. Pancreatoblastoma in an older adult. Arch Pathol Lab Med 1995; 119: 547-51. – reference: 4) Klimstra DS, Wenig BM, Adair CF, Heffess CS. Pancreatoblastoma. A clinicopathologic study and review of the literature. Am J Surg Pathol 1995; 19: 1371-89. – reference: 15) Robin E, Terris B, Valverde A, et al. Pancreatoblastoma in adults. Gastroenterol Clin Biol 1997; 21: 880-3. – reference: 11) Cavallini A, Falconi M, Bortesi L, Crippa S, Barugola G, Butturini G. Pancreatoblastoma in adults: a review of the literature. Pancreatology 2009; 9: 73-80. – reference: 25) Balasundaram C, Luthra M, Chavalitdhamrong D, Chow J, Khan H, Endres PJ. Pancreatoblastoma: a rare tumor still evolving in clinical presentation and histology. JOP 2012; 13: 301-3. – reference: 14) Levey JM, Banner BF. Adult pancreatoblastoma: a case report and review of the literature. Am J Gastroenterol 1996; 91: 1841-4. – reference: 3) Du E, Katz M, Weidner N, Yoder S, Moosa AR, Shabaik A. Ampullary pancreatoblastoma in an elderly patient: a case report and review of the literature. Arch Pathol Lab Med 2003; 127: 1501-5. – reference: 20) Zhu LC, Sidhu GS, Cassai ND, Yang GC. Fine-needle aspiration cytology of pancreatoblastoma in a young woman: report of a case and review of the literature. Diagn Cytopathol 2005; 33: 258-62. |
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| Snippet | 症例は30代女性．上腹部痛を主訴に当院を受診．CT上，膵頭部に37mmの境界明瞭な充実性腫瘤を認め，内部は不均一でわずかに造影され，石灰化を有していた．EUS-FNAを施... 「要旨」:症例は30代女性. 上腹部痛を主訴に当院を受診. CT上, 膵頭部に37mmの境界明瞭な充実性腫瘤を認め, 内部は不均一でわずかに造影され, 石灰化を有していた.... |
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| Title | EUS-FNAが診断に有用であった成人膵芽腫の一例 |
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