Intraductal Oncocytic Papillary Neoplasm of the Pancreas (IOPN) and IOPN with Associated Invasive Component

2021 ◽  
pp. 1-4
Author(s):  
Eva Karamitopoulou-Diamantis
Keyword(s):  
Invasive Component ◽  
Papillary Neoplasm

scholarly journals CD117 Is a Specific Marker of Intraductal Papillary Mucinous Neoplasms (IPMN) of the Pancreas, Oncocytic Subtype

2020 ◽  
Vol 21 (16) ◽  
pp. 5794 ◽  
Author(s):  
Paola Mattiolo ◽  
Seung-Mo Hong ◽  
Gaetano Paolino ◽  
Borislav C. Rusev ◽  
Giovanni Marchegiani ◽  
...  
Keyword(s):  
Specific Marker ◽  
Fusion Genes ◽  
Immunohistochemical Expression ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Additional Tool ◽  
Mucinous Neoplasm ◽  
Invasive Component ◽  
Mucinous Neoplasms ◽  
Papillary Neoplasm ◽  
Shed Light

The intraductal oncocytic papillary neoplasm (IOPN) of the pancreas has been recognized by WHO classification as a unique intraductal papillary mucinous neoplasm (IPMN) category. IOPN is composed of oxyphil cells, usually expressing MUC5AC, MUC6, and Hep Par-1, and harboring PRKACA/B fusion genes as their genetic hallmark. Although IOPNs are associated with an infiltrative adenocarcinoma in up to 30% of cases, the survival rate after surgical resection approaches 100%. This highlights the importance of the correct IOPN diagnosis, above all in cases with an associated invasive component. In this study, the immunohistochemical expression of CD117 was investigated in 111 IPMNs, including 17 oncocytic, 45 gastric, 20 pancreatico-biliary, and 29 intestinal IPMNs. We also tested the expression of MUC5AC, MUC6, and Hep Par-1 in the IOPN cohort. CD117 positivity was significantly more frequent in IOPNs compared to the other IPMN subtypes (p < 0.0001). Furthermore, within IOPN, a lower or absent CD117, MUC5AC, MUC6, and Hep Par-1 expression tended to be associated with the presence of an infiltrative component. Our findings shed light into the biology of these complex lesions, which are confirmed to be a distinctive IPMN subtype; notably, CD117 emerged as a potential, additional tool in the differential diagnosis of IPMNs.

Intraductal Papillary Adenocarcinoma Of The Bile Duct With Associated Invasive Neuroendocrine Component: Case Report

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S68-S68
Author(s):  
A Alhussain ◽  
A Abraham ◽  
D Grunes ◽  
C Subramony
Keyword(s):  
Bile Duct ◽  
Bile Duct Carcinoma ◽  
Cell Nuclei ◽  
Duct Carcinoma ◽  
Intraductal Growth ◽  
Neuroendocrine Markers ◽  
Intraductal Papillary Neoplasm ◽  
Invasive Component ◽  
Intraductal Component ◽  
Papillary Neoplasm

Abstract Casestudy Intraductal papillary neoplasm of the bile duct (IPNB) is a variant of bile duct carcinoma that is characterized by intraductal growth and better outcomes compared with common cholangiocarcinoma. IPNBs are mainly found in patients from Far Eastern countries, where hepatolithiasis and clonorchiasis are endemic. Approximately 40%-80% of IPNBs are associated with invasive carcinoma. The invasive carcinomas are most often tubular or mucinous type. Invasive neuroendocrine component has not been previously described. We present a case of 69 year-old African American male who presented with worsening abdominal pain and jaundice over few months. Computed tomography showed 4 cm mass near the porta hepatis with massive ductal dilatation. A fine needle aspiration of the mass was performed and a diagnosis of adenocarcinoma was made. Subsequently, the patient underwent Right Trisegmentectomy. Conclusion Histologic sections revealed intraductal papillary neoplasm in the bile duct lumina. The papillae were lined by columnar epithelial cells with delicate fibrovascular cores. The tumor cell nuclei were slightly elongated, hyperchromatic and basally located without significant multilayering. The cytoplasm was eosinophilic with occasional intestinal differentiation. Frank invasion of the stalk and underlying periductular tissues was identified. Interestingly; the invasive component had different cytological features than the intraductal component, it was composed of small to medium sized cells with granular cytoplasm. The nuclei were uniform and round with “salt and pepper” chromatin. The invasive component stained positively for the neuroendocrine markers (Synaptophysin, Chromogranin and CD56), whereas the intraductal component stained positively for CK7, CK20 and CDX2 and negative for neuroendocrine markers. Three years later, a recurrent tumor was found in the left lobe on imaging. Biopsy of the lesion showed metastatic neuroendocrine carcinoma. The intraductal papillary neoplasm with invasive neuroendocrine component is very unusual tumor, we think more studies are warranted to best evaluate the treatment options and the prognosis of such neoplasms.

scholarly journals Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs: A case report

2020 ◽  
Vol 26 (3) ◽  
pp. 366-374
Author(s):  
Nguyen Hai Nam ◽  
Kojiro Taura ◽  
Masashi Kanai ◽  
Keita Fukuyama ◽  
Norimitsu Uza ◽  
...  
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Intraductal Papillary Neoplasm ◽  
Invasive Component ◽  
Papillary Neoplasm ◽  
The Brain

scholarly journals Intraductal papillary neoplasm of bile ducts: report of a case and literature review

2019 ◽  
Vol 6 (7) ◽  
pp. 2579
Author(s):  
Nuray Colapkulu ◽  
Gurhan Bas ◽  
Fatih Buyuker ◽  
Damla Beyazadam ◽  
Ibrahim A. Ozemir ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Case Reports ◽  
Case Series ◽  
Endoscopic Biopsy ◽  
World Health ◽  
Retrospective Case ◽  
Intraductal Papillary Neoplasm ◽  
Invasive Component ◽  
Papillary Neoplasm

A 67 year old male with right upper quadrant abdominal pain diagnosed with intraductal papillary neoplasm of bile ducts (IPNB) by endoscopic biopsy. The patient was treated surgically and disease free on first year follow-up. Intraductal papillary neoplasm of bile duct (IPNB) is a rare entity with malignant counterparts and recently classified by The World Health Organization. The aim of this study is to present a case of IPNB and review the literature. Pubmed/MEDLINE was searched and articles were extracted. Twenty four case reports and 17 retrospective case series were evaluated. From 41 studies, 824 cases were included. There was slight male predominancy among patients and almost all cases were from eastern countries. Even though the etiology remains unclear, hepatolithiasis was the most common potential etiological association. Most cases were treated with surgical intervention. More than half of the 577 resected specimens had invasive component. Incidence rate of histopathological subtypes were as fallowed: Intestinal (35%), pancreaticobiliary (32%), gastric (19%) and oncocytic (12%). Intraductal papillary neoplasm of bile duct has an increased malignancy rates at postoperative pathological diagnosis, consequently early surgical management is important.

scholarly journals Branch-type intraductal papillary neoplasm of the bile duct treated with laparoscopic anatomical resection: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Rumi Matono ◽  
Mizuki Ninomiya ◽  
Kazutoyo Morita ◽  
Takahiro Tomino ◽  
Yumi Oshiro ◽  
...  
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Anatomical Resection ◽  
Intraductal Papillary Neoplasm ◽  
Papillary Neoplasm ◽  
Branch Type

scholarly journals Diffuse PRAME Expression Is Highly Specific for Thin Melanomas in the Distinction from Severely Dysplastic Nevi but Does Not Distinguish Metastasizing from Non-Metastasizing Thin Melanomas

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3864
Author(s):  
Maximilian Gassenmaier ◽  
Matthias Hahn ◽  
Gisela Metzler ◽  
Jürgen Bauer ◽  
Amir Sadegh Yazdi ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Diagnostic Interpretation ◽  
Dysplastic Nevi ◽  
Melanocytic Tumors ◽  
Invasive Component ◽  
Uncertain Significance ◽  
Long Term Follow Up

Background: PReferentially expressed Antigen in MElanoma (PRAME) immunohistochemistry is increasingly used as diagnostic adjunct in the evaluation of melanocytic tumors. The expression and prognostic significance of PRAME in melanomas ≤1.0 mm and its diagnostic utility in the distinction from severely dysplastic compound nevi (SDN) have not been studied. Methods: We investigated and compared the immunohistochemical PRAME expression in 70 matched thin metastasizing and non-metastasizing melanomas and 45 nevi from patients with long-term follow-up (35 SDN and 10 unequivocally benign compound nevi). Results: Diffuse PRAME staining in >75% of lesional epidermal and dermal melanocytes identified 58.6% of thin melanomas but did not distinguish metastasizing from non-metastasizing melanomas (p = 0.81). A superficial atypical melanocytic proliferation of uncertain significance, in which the final diagnostic interpretation favored a SDN was the only nevus with diffuse PRAME expression (1/45). Melanomas and SDN with PRAME immunoreactivity exhibited different staining patterns. Most melanomas (67.6%) showed uniform PRAME expression in the in situ and invasive component, whereas most SDN (81.0%) showed a decreasing gradient with depth. Conclusion: Diffuse intraepidermal and dermal PRAME staining is highly specific for melanomas in the distinction from SDN. PRAME expression is not a prognostic biomarker in melanomas ≤1.0 mm.

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