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Korean J Med > Volume 86(5); 2014 > Article
The Korean Journal of Medicine 2014;86(5): 598-602.
작은 크기에서 현저한 주췌관 확장과 췌장실질 위축을 동반한 신경내분비종
원성현1, 홍승모2, 김명환1, 박상우1, 최윤식1, 장일영1, 김형중3
1울산대학교 의과대학 서울아산병원 내과
2울산대학교 의과대학 서울아산병원 병리과
3울산대학교 의과대학 서울아산병원 영상의학과
A Small Pancreatic Neuroendocrine Tumor with Marked Pancreatic Duct Dilatation and Parenchymal Atrophy
Sunghyun Won1, Seung-Mo Hong2, Myung-Hwan Kim1, Sangwoo Park1, Yunsik Choi1, Il-Young Jang1, Hyoung Jung Kim3
1Departments of Internal Medicine University of Ulsan College of Medicine, Seoul, Korea
2Departments of Pathology University of Ulsan College of Medicine, Seoul, Korea
3Departments of Radiology University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Myung-Hwan Kim ,Tel: +82-2-3010-3183, Fax: +82-2-3010-0824, Email: mhkim@amc.seoul.kr
Received: August 14, 2013;   Revised: August 19, 2013;   Accepted: September 13, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Pancreatic ductal adenocarcinomas often cause marked pancreatic duct dilatation and associated parenchymal atrophy. We present the case of a small pancreatic neuroendocrine tumor with upstream pancreatic duct dilatation and severe parenchymal atrophy. A small enhancing tumor was observed at the head of the pancreas on computed tomography (CT). Endoscopic ultrasonographyguided fine-needle aspiration was negative for malignancy. We performed a pylorus-preserving pancreatoduodenectomy since we could not exclude the presence of pancreatic ductal adenocarcinoma. The pathological and immunohistochemical examination revealed a serotonin-positive neuroendocrine tumor, measured 1.0 × 0.5 cm. The pathological specimen was remarkable for the marked stromal fibrosis in the area of the tumor, which resulted in narrowing of the main pancreatic duct. Here, we report a rare small pancreatic neuroendocrine tumor, the CT image of which resembled that of pancreatic ductal adenocarcinoma, in which the expression of serotonin and associated fibrosis might be a possible mechanism for the marked main pancreatic duct dilatation. (Korean J Med 2014;86:598-602)
Keywords: Pancreatic duct dilatation; Pancreas neuroendocrine tumor; Serotonin
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