胰腺癌

介绍
体格检查时出现腹部疼痛和明显肿块。

患者资料
年龄：75岁
性别：女

CT

Axial C+ arterial phase


Axial C+ arterial phase


Axial C+ delayed


Coronal C+ arterial phase


Sagittal C+ arterial phase

胰体内60×40mm肿块伴远端实质萎缩改变及胰管扩张。腹腔动脉主干、脾动脉和肝动脉的近端部分被肿块包裹。此外，SMV还受到肿块的浸润和阻碍。在病变节段附近有几个小的淋巴结肿大。

案例讨论

病理证实胰腺癌伴血管受累和局部淋巴结病变。

胰腺导管腺癌占所有胰腺肿瘤的绝大多数（约90%），仍然是一种预后很差、发病率很高的疾病。

在影像学上，通常表现为低密度肿块，边缘不清，可能包裹血管和胆总管。

流行病学

胰腺癌占所有胃肠道恶性肿瘤死亡的22%，占所有癌症死亡的5%。一般来说，它是老年人的恶性肿瘤，80%以上的病例发生在60岁以后。

参考资料：
1. Evans DB, Pisters PW, Abbruzzese JL. Pancreatic cancer. Springer Verlag. (2002) ISBN:0387951857. Read it at Google Books - Find it at Amazon
2. Greene FL, Cancer AJ, Society AC. AJCC cancer staging handbook, from the AJCC cancer staging manual. Springer Verlag. (2002) ISBN:0387952705. Read it at Google Books - Find it at Amazon
3. Lu DS, Reber HA, Krasny RM et-al. Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR Am J Roentgenol. 1997;168 (6): 1439-43. AJR Am J Roentgenol (abstract) - Pubmed citation
4. DeVita VT, Lawrence TS, Rosenberg SA et-al. DeVita, Hellman, and Rosenberg's cancer, principles & practice of oncology. Lippincott Williams & Wilkins. (2008) ISBN:0781772079. Read it at Google Books - Find it at Amazon
5. Mergo PJ, Helmberger TK, Buetow PC et-al. Pancreatic neoplasms: MR imaging and pathologic correlation. Radiographics. 17 (2): 281-301. Radiographics (abstract) - Pubmed citation
6. Schenk M, Schwartz AG, O'neal E et-al. Familial risk of pancreatic cancer. J. Natl. Cancer Inst. 2001;93 (8): 640-4. J. Natl. Cancer Inst. (link) - Pubmed citation