空肠异位胰腺伴胰岛细胞瘤样增生并肠梗阻误诊为神经内分泌肿瘤病理分析

目的探讨小肠异位胰腺的临床病理学特征及鉴别诊断.方法观察1例空肠异位胰腺伴胰岛细胞增生并发肠梗阻患者的临床表现,依据组织病理学特征并结合相关文献讨论其临床病理特点.结果患者术中空肠系膜缘对侧肠壁见一肿物,大小约2 cm×1 cm×0.8 cm,表面呈结节样,质地韧,活动度差,术中行快速病理学检查,结果为(空肠)神经内分泌肿瘤,术后石蜡切片结果为空肠异位胰腺伴胰岛细胞增生.结论异位胰腺是一种比较罕见的先天性异位器官,大量增生的胰岛细胞单独存在,呈团状.石蜡切片显示:空肠黏膜下有腺泡、导管及胰岛结构,系胰岛细胞增生.

Clinicopathological Analysis of Jejunal Ectopic pancreas Combined with Islet Cell Tumor Like Hyperplasia and Ileum Misdiagnosed as Neuroendocrine Tumor

Objective To investigate the clinicopathological features and diagnosis of jejunal ectopic pancreatology.Method The clinical manifestations and histopathological features of 1 cases with jejunal ectopic pancreas with islet cell tumor like hyperplasia and ileus,and combining the pertinent literature to discuss the clinicopathologic features.Results During the surgery,a mass 2 cm×1 cm×0.8 cm lying in the intestinal wall that located in the opposite side of mesojejunum was found.The mass had nodular surface,toughness texture,and poor activity.The result of rapid intraoperative pathological examination was jejunal neuroendocrine tumors,but the results of paraffin section was jejunal ectopic pancreatology with islet cell tumor like hyperplasia. Conclusion The heterotopic pancreas that had lack of specific clinical manifestations was a rare congenital ectopic organ.The histological features of this case were very special,accompanying massive lone hyperplasia of islet cells,which were separated from the pancreatic tissue.The paraffin section showed gland vesicle,catheter and islet structure beneath the jejunum mucosa,and islet cell hyperplasia was also observed.