Comparative Study of Clinical Pathology of Solid-Pseudopapillary Tumor of The Pancreas and Islet Cell Tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Shaoqin ¹ , ZOU Shengquan ¹ , LI Hong ¹ , DAI Qibao ²

1.Department of General Surgery, The Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;;
2.Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China;

Corresponding author：

Keywords：

Solid-pseudopapillary tumor of the pancreas; Islet cell tumor; Clinical pathology; Differential diagnosis; X-ray computed tomography

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Objective To investigate differential points of clinical symptoms and pathology of solid-pseudopapillary tumor of the pancreas (SPTP) and islet cell tumor (ICT). Methods Fifteen cases of SPTP and twelve cases of ICT were studied in this retrospective research. Clinical symptom, pathologic feature and computed tomography (CT) image of patients with both tumors were analyzed, and the imaging features were compared with pathological results. Results The mean age of SPTP patients was 22.4 year-old. Twelve patients with SPTP presented a palpable abdominal mass as the initial symptom. It was observed that the tumor cells were located in a pseudopapillary pattern with a fibro-vascular core histologically. On the CT images, a mixture of solid and cystic structures could be seen in all the tumors. After taking enhanced CT scan, the solid portion was slightly enhanced in the arterial phase and the contrast intensity increased in the portal venous phase. On the other hand, the mean age of ICT patients was 39.3 year-old. The major symptom was due to the function of islet cell tumor, which was typical in 8 patients, presenting as Whipple triad. Histologically, cells demonstrated in trabecular, massive, acinar or solid patterns, and the blood supply of the tumor was abundant. On the CT images, most small tumors were difficulty to be detected. ICT could be markedly enhanced in the arterial phase and slightly enhanced in the portal venous phase on post-contrast CT scan. Conclusion Clinical symptom, pathologic feature and CT scanning are helpful to differentiate SPTP from ICT.

Citation： CHEN Shaoqin,ZOU Shengquan,LI Hong,DAI Qibao. Comparative Study of Clinical Pathology of Solid-Pseudopapillary Tumor of The Pancreas and Islet Cell Tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(11): 835-839. doi: Copy

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7.	Chen SQ, Zou SQ, Dai QB, et al. Clinical analysis of solid-pseudopapillary tumor of the pancreas: report of 15 cases[J]. Hepatobiliary Pancreat Dis Int, 2008; 7(2)∶196.
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13.	Chen SQ, Zou SQ, Dai QB, et al. The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas: report of 9 cases[J]. JNMU, 2007; 21(6)∶398.
14.	Dajbog E, Lefter LP, Scripcariu V, et al. Diagnostic features of benign pancreatic insulinomas. An analysis of three cases[J]. J Gastrointestin Liver Dis, 2006; 15(1)∶61.
15.	Buetow PC, Buck JL, Pantongrag-Brown L, et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases [J]. Radiology, 1996; 199(3)∶707.
16.	Dong DJ, Zhang SZ. Solid-pseudopapillary tumor of the pancreas: CT and MRI features of 3 cases[J]. Hepatobiliary Pancreat Dis Int, 2006; 5(2)∶300.
17.	李传福，刘松涛，马祥兴．螺旋CT双期增强扫描诊断胰岛素瘤(附13例报告) [J]. 中华放射学杂志， 1999; 33(7)∶ 483.
18.	程涛，韦炜，韩萍．胰岛细胞瘤的CT表现与鉴别诊断 [J]. 临床放射学杂志， 2002; 21(11)∶869.
19.	王志强，王向东，程留芳．彩色多普勒超声内镜、 CT和腹部超声术前定位诊断胰岛细胞瘤 [J]. 中国医学影像学杂志， 2004; 12(3)∶161.
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1. Frantz VK. Tumors of the pancreas [A]. In: Frantz VK Eds. Atlas of Tumour Pathology [M].Washington, DC: Armed Forces Institute of Pathology, 1959∶32-33.
2. Kloppel G, Solcia E, Longnecker DS, et al. Histological typing of tumors of the exocrine pancreas[A]. In: World Health Organisation. International histological classification of tumors[C]. 2nd Ed. Berlin/Heidelberg/New York: Springer, 1996∶120-128.
3. Kosmahl M, Seada LS, Jnig U, et al. Solid-pseudopapillary tumor of the pancreas: its origin revisited[J]. Virchows Arch, 2000; 436(5)∶473.
4. Berretta S, Barbagallo E, D’Agata A, et al. Frantz’s solid cystic papillary pancreatic carcinoma[J]. Minerva Chir, 2001; 56(4)∶413.
5. Santini D, Poli F, Lega S. Solid-papillary tumors of the pancreas: histopathology[J]. JOP, 2006; 7(1)∶131.
6. Chen C, Jing W, Gulati P, et al. Melanocytic differentiation in a solid pseudopapillary tumor of the pancreas[J]. J Gastroenterol, 2004; 39(6)∶579.
7. Chen SQ, Zou SQ, Dai QB, et al. Clinical analysis of solid-pseudopapillary tumor of the pancreas: report of 15 cases[J]. Hepatobiliary Pancreat Dis Int, 2008; 7(2)∶196.
8. 张显平，刘永茂．胰腺实性假乳头状肿瘤1例报道 [J]. 中国普外基础与临床杂志， 2007; 14(6)∶638.
9. Liang H, Wang P, Wang XN, et al. Management of nonfunctioning islet cell tumors[J]. World J Gastroenterol, 2004; 10(12)∶1806.
10. Kamat RN, Naik LD, Joshi RM, et al. Solid pseudopapillary tumor of the pancreas[J]. Indian J Pathol Microbiol, 2008; 51(2)∶271.
11. Swerdlow SH. Pediatric follicular lymphomas, marginal zone lymphomas, and marginal zone hyperplasia[J].Am J Clin Pathol, 2004; 122 Suppl∶S98.
12. 李卓明，万珍玲，刘保安．胰腺实性假乳头状瘤与胰岛细胞瘤鉴别诊断的探讨 [J]. 诊断病理学杂志， 2005; 12(5)∶329.
13. Chen SQ, Zou SQ, Dai QB, et al. The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas: report of 9 cases[J]. JNMU, 2007; 21(6)∶398.
14. Dajbog E, Lefter LP, Scripcariu V, et al. Diagnostic features of benign pancreatic insulinomas. An analysis of three cases[J]. J Gastrointestin Liver Dis, 2006; 15(1)∶61.
15. Buetow PC, Buck JL, Pantongrag-Brown L, et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases [J]. Radiology, 1996; 199(3)∶707.
16. Dong DJ, Zhang SZ. Solid-pseudopapillary tumor of the pancreas: CT and MRI features of 3 cases[J]. Hepatobiliary Pancreat Dis Int, 2006; 5(2)∶300.
17. 李传福，刘松涛，马祥兴．螺旋CT双期增强扫描诊断胰岛素瘤(附13例报告) [J]. 中华放射学杂志， 1999; 33(7)∶ 483.
18. 程涛，韦炜，韩萍．胰岛细胞瘤的CT表现与鉴别诊断 [J]. 临床放射学杂志， 2002; 21(11)∶869.
19. 王志强，王向东，程留芳．彩色多普勒超声内镜、 CT和腹部超声术前定位诊断胰岛细胞瘤 [J]. 中国医学影像学杂志， 2004; 12(3)∶161.
20. 曾蒙苏，严福华，周康荣，等．非功能性胰内分泌肿瘤的螺旋CT表现 [J]. 中华放射学杂志， 2003; 37(6)∶528.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparative Study of Clinical Pathology of Solid-Pseudopapillary Tumor of The Pancreas and Islet Cell Tumor

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