目的分析胰腺实性假乳头状瘤(solid-pseudopapillary tumor of pancreas, SPTP)超声误诊原因,提高超声医师对本病的认识。方法回顾性分析我院经手术病理检查证实的20例SPTP超声误诊病例资料。结果本组4例酗酒者、2例胰腺炎病史者及2例胰腺外伤者,在随访既往疾病时发现胰腺病灶;3例甲状腺功能亢进症患者及1例长期节食者,入院后常规检查发现胰腺病变;8例无明确既往史者在体检时发现胰腺病变。20例超声首诊均误诊,分别误诊为假性囊肿8例、胰腺癌6例、胰岛细胞瘤4例、无功能性胰腺神经内分泌肿瘤2例,均行手术治疗经病理检查证实为SPTP,且胰管及胆管均未见扩张。结论 SPTP临床表现不典型,超声声像图具有一定的特征性,特别是当年轻女性胰腺区出现较大的囊实性包块时,应想到本病可能并加以鉴别,确诊需依赖手术病理检查。
Objective To analyze the causes of misdiagnosis of solid pseudopapillary tumor of the pancreas (SPTP) by ultrasonography and to improve the understanding of the disease by doctors specializing in ultrasonic medicine. Methods To analyze the causes of misdiagnosis of solid pseudopapillary tumor of the pancreas (SPTP) by ultrasonography and to improve the understanding of the disease by doctors specializing in ultrasonic medicine. Results In this group, 4 alcoholics, 2 patients with a history of pancreatitis and 2 patients with pancreatic trauma were found to have pancreatic lesions during follow-up of previous diseases;3 patients with hyperthyroidism and 1 patient with long-term diet were found to have pancreatic lesions by routine examination after admission;8 patients with no clear prior history were found to have pancreatic lesions during physical examination. All the 20 cases were misdiagnosed at initial visit, including pseudocysts in 8 cases, pancreatic cancer in 6 cases, islet cell tumors in 4 cases and non-functional pancreatic neuroendocrine tumors in 2 cases. All of them received treatment for SPTP which was confirmed by pathological examination, and no dilatation of pancreatic duct and bile duct was observed. Conclusion SPTP has atypical clnical manifestations, but has a characteristic ultrasonogram. Especially for young women with large cystic and solid masses in the pancreatic region, SPTP should be considered and differentiated. Surgical and pathological examination is necessary to make a definite diagnosis.
Clinical Misdiagnosis & Mistherapy