scholarly journals Challenge in differentiation of pancreatic cystic neoplasms between intraductal papillary mucinous neoplasm and mucinous cystic neoplasm: A case report

2020 ◽  
Vol 7 (3) ◽  
pp. 152-157
Author(s):  
Wei‐Chin Pan ◽  
Ming‐Jen Chen ◽  
Pao‐Shu Wu ◽  
Chih‐Jen Chen
Keyword(s):  
Case Report ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Neoplasms ◽  
Mucinous Neoplasm ◽  
Pancreatic Cystic Neoplasms

scholarly journals Main-duct intraductal papillary mucinous neoplasm of the pancreas: a case report

2012 ◽  
Vol 6 (4) ◽  
pp. 127-134
Author(s):  
Natalia Manetti ◽  
Clara Faini ◽  
Francesca Bucciero ◽  
Giulia Razzolini ◽  
Maria Marsico ◽  
...  
Keyword(s):  
Intraductal Papillary Mucinous Neoplasm ◽  
Tumour Size ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Mass ◽  
Cystic Neoplasm ◽  
Main Duct ◽  
Branch Duct ◽  
Recurrent Acute Pancreatitis ◽  
Mucinous Neoplasm ◽  
Wirsung Duct

Three distinct entities among non-inflammatory cystic lesions of the pancreas have been defined: intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN) and mucinous cystic neoplasm (MCN). IPMN is characterized by intraductal papillary growth and thick mucus secretion: its incidence has dramatically increased since its initial description. These lesions probably can progress towards invasive carcinoma. IPMNs are symptomatic in most cases: the typical presentation is a recurrent acute pancreatitis, without evident cause, of low or moderate severity. The diagnosis is usually based upon the imaging (CT/cholangio-MRI) demonstrating a pancreatic cystic mass, involving a dilated main duct, eventually associated to some filling defects, or a normal Wirsung duct communicating with the cyst lesion. Surgical treatment is generally indicated for main duct IPMN and branch duct IPMN with suspected malignancy (tumour size ≥ 30 mm, mural nodules, dilated main pancreatic duct, or positive cytology) or prominent symptoms. Herein we present a case of IPMN of the main duct which occurred with abdominal and back pain associated with weight loss. After the diagnosis, she successfully underwent surgery and is now in a follow-up program.

scholarly journals Cytologic Assessment of Cystic/Intraductal Lesions of the Pancreatobiliary Tract

2021 ◽  
Author(s):  
Michelle D. Reid
Keyword(s):  
Fine Needle Aspiration ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Imaging Techniques ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Fine Needle ◽  
Mucinous Neoplasm

Context.— Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic ultrasound/computed tomography/magnetic resonance imaging–guided fine-needle aspiration biopsies from these lesions have become an integral part of pathologists' daily practice. Because patient management has become increasingly conservative, accurate preoperative diagnosis is critical. Cytologic distinction of low-risk (pseudocysts, serous cystadenoma, lymphoepithelial cysts, and squamoid cysts of the pancreatic duct) from high-risk pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) requires incorporation of clinical, radiologic, and cytologic findings, in conjunction with chemical and molecular analysis of cyst fluid. Cytopathologists must ensure appropriate specimen triage, along with cytologic interpretation, cyst classification, and even grading of some (mucinous) cysts. Epithelial atypia in mucinous cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) has transitioned from a 3-tiered to a 2-tiered classification system, and intraductal oncocytic papillary neoplasms and intraductal tubulopapillary neoplasms have been separately reclassified because of their distinctive clinicopathologic characteristics. Because these lesions may be sampled on brushing or fine-needle aspiration biopsy, knowledge of their cytomorphology is critical. Objective.— To use an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions (incorporating clinical, radiologic, and cytologic findings with [chemical/molecular] cyst fluid analysis and ancillary stains) for definitive diagnosis and classification. Data Sources.— Review of current literature on the cytopathology of cystic/intraductal pancreatobiliary tract lesions. Conclusions.— Our knowledge/understanding of recent updates in cystic/intraductal pancreatobiliary lesions can ensure that cytopathologists appropriately triage specimens, judiciously use and interpret ancillary studies, and incorporate the studies into reporting.

Ultrasound Diagnosis of Benign or Malignant Tumors in Intraductal Papillary Mucinous Neoplasm and Mucinous Cystic Neoplasm

Choonpa Igaku ◽  
2006 ◽  
Vol 33 (6) ◽  
pp. 641-646
Author(s):  
Yuichi OUCHIDA ◽  
Katsuhiko HORII ◽  
Hiroko OKA ◽  
Shigeki YOKOTA ◽  
Keiko SAKURADA ◽  
...  
Keyword(s):  
Intraductal Papillary Mucinous Neoplasm ◽  
Malignant Tumors ◽  
Mucinous Cystic Neoplasm ◽  
Ultrasound Diagnosis ◽  
Cystic Neoplasm ◽  
Mucinous Neoplasm

scholarly journals European evidence-based guidelines on pancreatic cystic neoplasms

Gut ◽  
2018 ◽  
Vol 67 (5) ◽  
pp. 789-804 ◽  
Author(s):  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Evidence Based ◽  
Indications For Surgery ◽  
Cystic Neoplasms ◽  
Serous Cystic Neoplasm ◽  
Pancreatic Cystic Neoplasms ◽  
Grade Methodology ◽  
Evidence Based Guidelines

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

scholarly journals Unique Presentation of Giant Metastatic Microcystic Serous Adenocarcinoma of the Pancreas

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Cyriac Abby Philips ◽  
Chetan Ramesh Kalal ◽  
Chhagan Bihari ◽  
Amrish Sahney ◽  
KN Chandan Kumar ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Solid Pseudopapillary Tumor ◽  
Serous Adenocarcinoma ◽  
Mucinous Neoplasm ◽  
Microcystic Adenoma ◽  
Adenocarcinoma Of The Pancreas

Tumors of the pancreas that contain substantial cystic components include mainly mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, solid pseudopapillary tumor, and cystadenomas (which encompass microcystic, macrocystic/oligocystic, and rare solid serous adenomas). Microcystic adenoma of the pancreas is a tumor that is benign in nature. Malignant transformation in the tumor with metastases is rare and only about 26 cases have been reported so far. Here we present a giant microcystic adenoma of the pancreas, possibly the largest ever malignant type in this group ever reported in the literature with extensive metastases to the liver and causing extensive compression and encasement on surrounding structures.

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