血中 NSE の上昇と骨シンチグラムで集積像を認めた膵 Solid and Cystic Tumor の1例

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An 11-year-old young woman with solid and cystic tumor of the pancreas was reported. She admitted with pain and mass in the upper abdomen after being kicked violently. Hematobiochemical studies showed normal levels of pancreatic enzymes and elevation of serum neuron-specific enolase (NSE) to 61.2 ng/ml. Abdominal CT scan showed well-defined tumor with a few low density area in the pancreas. Abdominal ultrasonogram showed a tumor with mixture of hypoechoic and echogenic area at the pancreatic body. Hypovascular tumor was seen by angiography. Bone scintigram with 99mTc showed abnormal accumulation in the area of the tumor. After admission the tumor gradually decreased in size. Three months later, 70% distal pancreatectomy was performed under the diagnosis of solid and cystic tumor of the pancreas. Gross pathologic examination revealed cystic degeneration and hemorrhagic necrosis apparently encapsulated by fibrous tissues. Microscopic examination showed solid, papillary and cystic patterns including sheets and pseudorossette formation. Solid area of the tumor contained PAS-positive droplets in the cytoplasm and intercellular portions. Immunohistochemical staining for NSE and neurofilament was positive in most of the tumor cells. Alpha-1-antitrypsin was partially positive. Electron microscopic examination showed many menbrane-bound granules with high electron density from 300 to SOOnm in diameter in the tumor cells. Eleva- tion of serum NSE and abnormal accumulation on the 99m-Tc bone scintigram should be recognized as one of the features of solid and cystic tumor of the pancreas.
日本小児外科学会の論文
1992-02-20

血中 NSE の上昇と骨シンチグラムで集積像を認めた膵 Solid and Cystic Tumor の1例

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