すいリンパ上皮嚢胞の１例

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  • A CASE OF LYMPHOEPITHELIAL CYST OF THE PANCREAS

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A 58-year-old man was incidentally found to have a cystic tumor in the tail of pancreas by abdominal ultrasonography on a medical checkup. The patient had had upper abdominal discomfort 4 years before, when no abnormality was found by abdominal CT scan. After admission to the hospital, contrasted CT scan revealed a tumor measuring 4.5cm in diameter with slight ring-enhancement in the tail of pancreas. Abdominal angiography showed irregularity of the splenic artery and hypervascularity at the capsule of the tumor. In addition to these findings, serum CA19-9 level was remarkably elevated. The tumor was diagnosed as cystic tumor of the pancreas with malignant potential. A distal pancreatectomy with a splenectomy was performed subsequently. Macroscopically, the tumor was capsulated by thick wall and contained keratinizing substances. Microscopically, the cyst wall was lined by stratified squamous epithelium with abundant lymphoid tissue. These pathological findings were compatible with the diagnosis of lymphoepithelial cyst of the pancreas. In the present case, the tumor enlarged in a relatively short period of 4 years with remarkable elevation of serum CA19-9 level and several radiological findings indicating a malignant disease.<br> Although lymphoepithelial cyst of the pancreas is a rare benign disease, it is desirable to resect the tumor in cases in which the differentiation between the disease and malignant pancreatic cystic neoplasm is difficult from clinical and radiological findings.

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