Abstract：
Pancreatic acinar cell carcinomas are glandular and have amphophilic/eosinophilic cytoplasm, presenting acinar, solid, and trabecular structures. Unusual histological features of acinar cell carcinoma are known, such as oncocytic, pleomorphic, spindle, and clear cell variants, but their clinical significance has not been well described. A man in his 70s was referred to our hospital because of elevated serum pancreatic enzymes. Contrast-enhanced abdominal computed tomography revealed slight swelling of the pancreatic head and suspension of the main pancreatic duct in the pancreatic body. He died only 14 days after admission. Gross findings at autopsy showed an ill-defined tumor located in the pancreatic head, involving the gastric and duodenal walls. Peritoneal dissemination, liver metastases, and lymph node metastases were also observed. Microscopically, tumor cells had moderate-to-severe nuclear atypia and amphophilic cytoplasm showing pleomorphism, and diffusely proliferated in solid pattern without lumina, were admixed with spindle cells. Immunohistochemically, tumor cells including pleomorphic and spindle cells were positive for B-cell lymphoma/leukemia 10 and trypsin. Consequently, the diagnosis was pancreatic acinar cell carcinoma with pleomorphic and spindle cells. We encountered a rare variant of pancreatic acinar cell carcinoma with pleomorphic and spindle cells. Clinically, our case showed rapid progression.
摘要：
胰腺腺泡细胞癌是腺状的，有两亲性/嗜酸性的细胞质，呈现腺泡，固体,和小梁结构。腺泡细胞癌的异常组织学特征是已知的，如嗜酸细胞,多形性，主轴,和透明细胞变体，但其临床意义尚未得到很好的描述。一名70多岁的男子因血清胰酶升高而被转诊到我们医院。对比增强的腹部计算机断层扫描显示胰头轻度肿胀，胰体中的主胰管悬吊。他在入院后仅14天死亡。尸检的总体结果显示，胰头有一个不明确的肿瘤，累及胃壁和十二指肠壁.腹膜播散,肝转移,淋巴结转移也观察到。微观上,肿瘤细胞具有中度至重度的核异型性和显示多态性的两性细胞质，并在没有发光的情况下以固体模式扩散增殖，与梭形细胞混合。免疫组织化学，包括多形性和梭形细胞在内的肿瘤细胞对B细胞淋巴瘤/白血病10和胰蛋白酶呈阳性。因此,诊断为胰腺腺泡细胞癌，多形性和梭形细胞。我们遇到了一种罕见的胰腺腺泡细胞癌变种，具有多形性和梭形细胞。临床上,我们的病例显示进展迅速.
