Abstract：
This study presents two cases of lipid-rich pancreatic neuroendocrine tumors (PanNETs), a rare variant posing significant diagnostic challenges in fine needle aspiration (FNA) cytology and small biopsies. The first case involves an elderly male with a pancreatic tumor, displaying distinct cytoplasmic vacuoles, while the second case is a middle-aged male present with a pancreatic tail mass exhibiting foamy cytoplasm and eccentric nuclei, infiltrating in the stroma. Both cases did not exhibit typical morphologic features of PanNET but demonstrated cytomorphologic features and infiltrative growth patterns that mimicked adenocarcinoma. Further work-up demonstrated that both tumors were immunoreactive for synaptophysin and chromogranin, and were interpreted as well-differentiated, PanNET, lipid-rich variant. The study highlights the overlapping morphological features between lipid-rich PanNETs and other pancreatic neoplasms and underscores the importance of comprehensive cytological and immunohistochemical analysis for accurately diagnosing this variant, particularly due to the risk of misinterpreting it as pancreatic adenocarcinoma. Recognizing lipid-rich PanNETs is crucial for appropriate clinical management, as their identification can significantly impact treatment decisions and patient outcomes.
摘要：
这项研究提出了两例富含脂质的胰腺神经内分泌肿瘤（PanNETs），一种罕见的变异，在细针穿刺（FNA）细胞学和小活检中提出了重大的诊断挑战。第一例涉及一名患有胰腺肿瘤的老年男性，显示明显的细胞质液泡，而第二例是一名中年男性，胰腺尾部肿块表现出泡沫状的细胞质和偏心核，渗入基质。这两个病例均未表现出PanNET的典型形态学特征，但表现出模仿腺癌的细胞形态学特征和浸润性生长模式。进一步的研究表明，两种肿瘤都对突触素和嗜铬粒蛋白具有免疫反应性，被解释为分化良好，PanNET,富含脂质的变体。该研究强调了富含脂质的PanNETs与其他胰腺肿瘤之间的重叠形态特征，并强调了全面的细胞学和免疫组织化学分析对于准确诊断该变异的重要性。特别是由于将其误解为胰腺腺癌的风险。认识到富含脂质的PanNETs对于适当的临床管理至关重要，因为它们的识别可以显着影响治疗决策和患者预后。
