Neuroendocrine carcinoma of the pancreas with similar genetic alterations to invasive ductal adenocarcinoma

被引:22
作者
Kimura T. [1 ]
Miyamoto H. [1 ]
Fukuya A. [1 ]
Kitamura S. [1 ]
Okamoto K. [1 ]
Kimura M. [1 ]
Muguruma N. [1 ]
Ikemoto T. [2 ]
Shimada M. [2 ]
Yoneda A. [3 ]
Bando Y. [3 ]
Takishita M. [4 ]
Takayama T. [1 ]
机构
[1] Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima
[2] Department of Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima
[3] Division of Pathology, Tokushima University Hospital, Tokushima
[4] Anan Kyoei Hospital, Tokushima
关键词
KRAS; Neuroendocrine carcinoma; p53; Pancreatic cancer; SMAD4;
D O I
10.1007/s12328-016-0655-6
中图分类号
学科分类号
摘要
Neuroendocrine carcinoma (NEC) of the pancreas is very rare, and its origin is not fully elucidated. Here, we present a case of a small-size NEC of the pancreas that is genetically similar to invasive ductal adenocarcinoma (IDA). A 65-year-old man was referred to our hospital due to obstructive jaundice and found to have a 12-mm solid tumor in the pancreas head. The tumor exhibited low vascularity on enhanced computed tomography, and endoscopic retrograde pancreatographic imaging revealed an irregular obstruction in a branch duct of the pancreas. The patient was thereby diagnosed with a pancreatic ductal cancer, and stomach-preserving pancreaticoduodenectomy with regional lymph node resection was performed. Histochemical analysis of the resected tumor showed that the neoplastic cells with scanty cytoplasm and hyperchromatic nuclei strongly expressed chromogranin A and synaptophysin. The Ki-67 index was 40 % in the most proliferative tumor regions, and the tumor was diagnosed as a NEC of the pancreas. However, in the analysis of genetic alterations of the tumor tissue, the neoplastic cells showed altered KRAS, TP53, and SMAD4/DPC4, suggesting that the NEC in our case is genetically related to IDA. Our data suggest that poorly differentiated IDAs may transform into NECs. © 2016, Japanese Society of Gastroenterology.
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页码:261 / 265
页数:4
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