scholarly journals Cystic and Papillary Neoplasm at the Hepatic Hilum Possibly Originating in the Peribiliary Glands

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Takashi Miyata ◽  
Katsuhiko Uesaka ◽  
Yasuni Nakanuma
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Tumor ◽  
Cystic Neoplasm ◽  
Endoscopic Retrograde ◽  
Cystic Neoplasms ◽  
Intraductal Papillary Neoplasm ◽  
Hepatic Hilum ◽  
Left Hepatic Trisectionectomy ◽  
Peribiliary Glands ◽  
Papillary Neoplasm

Cystic neoplasms of the liver are divided into two types: mucinous cystic neoplasm and cystic intraductal papillary neoplasm of the bile duct. We herein report two cases of cystic and papillary neoplasm of the liver which differed from the abovementioned types.Case  1.A 70-year-old man. Radiologically, a cystic tumor measuring 20 mm in diameter was found at the hepatic hilum. Right hepatectomy was performed under a diagnosis of intrahepatic cholangiocarcinoma (iCCA) based on the imaging findings.Case  2.A 70-year-old man. Radiologically, a cystic tumor measuring 60 mm in diameter was found at the hepatic hilum. Under a diagnosis of iCCA, left hepatic trisectionectomy was performed. In both cases, endoscopic retrograde cholangiography did not demonstrate communication between the cystic tumor and adjacent bile ducts. Pathologically, these two tumors were cystic neoplasms located at the hepatic hilum and were morphologically characterized by an intracystic papillary neoplasm composed of diffuse high-grade dysplasia and associated with an invasive carcinoma. Ovarian-like stroma was not found in the capsule of these tumors. Interestingly, there were peribiliary glands near these tumors, and MUC6 was expressed in these papillary neoplasms as well as in the peribiliary glands. These neoplasms might have arisen from the peribiliary glands.

scholarly journals Mucinous cystic neoplasm of the liver with biliary communication: an exception to the current classification

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227063 ◽  
Author(s):  
Santhosh Anand ◽  
Sandip Chandrasekar ◽  
Kalayarasan Raja ◽  
Biju Pottakkat
Keyword(s):  
Who Classification ◽  
Mucinous Cystadenoma ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Neoplasms ◽  
Intraductal Papillary Neoplasm ◽  
Rare Tumours ◽  
Current Classification ◽  
Biliary Communication ◽  
Papillary Neoplasm

Cystic neoplasms of the liver are rare tumours. According to the recent WHO classification, they are classified into mucinous cystic neoplasm and intraductal papillary neoplasm based on the presence of ovarian-like stroma and biliary communication. We report two rare cases of mucinous cystadenoma of the liver with biliary communication and discuss the shortcomings of current classification.

Intralobular Distribution of Ovarian-like Stroma in Pancreatic Mucinous Cystic Neoplasms: Hypothesis on Its Tumorigenesis

2021 ◽  
Author(s):  
Yuki Fukumura ◽  
Yuko Kinowaki ◽  
Yoko Matsuda ◽  
Masaru Takase ◽  
Momoko Tonosaki ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Wnt Pathway ◽  
Smooth Muscle Actin ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Pancreatic Ducts ◽  
Low Grade ◽  
Muscle Actin ◽  
Cystic Neoplasms ◽  
Mucinous Cystic Neoplasms

Abstract Pancreatic mucinous cystic neoplasm (MCN) harbors two histological components, tumor epithelia and ovarian-like stroma (OLS). To examine the tumorigenesis of pancreatic MCNs, this study analyzed the distribution, amount, immunohistochemical phenotype, presence of theca cells of the OLS, and the alteration of tumor epithelium of 29 surgically resected MCN cases and compared them with tumor sizes. Non-mucinous type epithelium was present in all low-grade MCNs but its ratio decreased with tumor size (p < 0.05), suggesting that epithelial mucinous changes are a progression phenomenon. The intralobular distribution of OLS was observed in 27.6 % of MCN cases and its existence related to a smaller size (p< 0.05), suggesting intralobular generation of MCNs. Nuclear expression of β-catenin was observed for OLS of everywhere, suggesting consistent activation of the Wnt pathway for OLS. Three MCN cases (10.3%) contained a-smooth muscle actin (SMA)-negative OLS, where OLS surrounding dilated pancreatic ducts or MCN cysts were a-SMA-positive and otherwise negative, suggesting that a-SMA-positivity is an acquired phenomenon of OLS. With this study, we could hypothesize that pancreatic MCNs may generate intralobularly. Epithelial mucinous change and a-SMA-positivity of OLS may be progression phenomena. This is the first study to show the intralobular distribution of OLS.

Mucinous Cystic Neoplasms of the Pancreas: How Much Preoperative Evaluation is Needed?

2010 ◽  
Vol 76 (8) ◽  
pp. 812-817 ◽  
Author(s):  
Tom P. Theruvath ◽  
Katherine A. Morgan ◽  
David B. Adams
Keyword(s):  
Operative Treatment ◽  
Endoscopic Ultrasound ◽  
Preoperative Evaluation ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Lesions ◽  
Mri Imaging ◽  
Diagnostic Dilemma ◽  
Cystic Neoplasms ◽  
Preoperative Workup

Cystic lesions of the pancreas are identified with increasing frequency by modern imaging. The mucinous cystic neoplasm (MCN) is treated with resection for its malignant potential. How much preoperative evaluation is needed before undertaking operation is frequently a diagnostic dilemma. A retrospective review of 32 patients who underwent resection of a MCN between 1994 and 2007 was performed to define the preoperative evaluation and operative treatment of MCN patients. Thirty-two patients (30 women; mean age 49) had histology-proven MCN. Twenty-seven patients had symptomatic cysts (84%). Five had a history of gallstones and/or acute pancreatitis. All patients were worked up with CT and/or MRI. Endoscopic ultrasound was performed in 14 (44%) and endoscopic retrograde cholangiopancreatography in six (18%). Cytology was obtained in 13 (40%). Pathology revealed 22 benign MCNs (68%), five malignant MCNs (16%), and five MCNs with borderline pathology. Preoperative workup including CT or MRI imaging and cytology suggested MCN as the lesion in 15 patients (46%). CT features by itself predicted MCN in three patients (9%). Cytology revealed another six patients (19%) with possible MCN. In this series, preoperative workup did not identify three of five patients with MCN malignancy. A preoperative diagnosis cannot be made in most patients with MCN. Operative treatment can be based on clinical presentation and CT imaging because endoscopic ultrasound and fine needle aspiration for evaluation may be misleading. Middle-aged women with cystic lesions in the tail of the pancreas without prior gallstone or pancreatitis history most typically fit the profile of the MCN patient.

scholarly journals Surgical resection for hepatic space occupying lesions: a histopathological analysis

2017 ◽  
Vol 5 (5) ◽  
pp. 2215
Author(s):  
Vani M. ◽  
Jeena Sam Kachappilly ◽  
Geetha K.
Keyword(s):  
Hepatic Resection ◽  
Liver Tumors ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Malignant Neoplasms ◽  
Histopathological Analysis ◽  
Neoplastic Diseases ◽  
Intraductal Papillary Neoplasm ◽  
Neoplastic Lesions ◽  
Malignant Liver

Background: Hepatic resections are done for both neoplastic and non-neoplastic diseases of liver with malignancies constituting a major share of cases. The objective of this study was to assess the various neoplatic and non-neoplastic lesions in hepatic resection specimens and to categorize the various histopathological types of primary and secondary liver tumors.Methods: The study was conducted in the Department of Pathology, Academy of Medical sciences, Pariyaram. This was a hospital based study which included 79 patients who underwent hepatic resection for space occupying lesions over a period of 5 years from January 2012 to December 2016. IHC was performed in cases with diagnostic dilemma.Results: Of the 79 cases, there were 45 males and 34 females with the age range of 22-85 years. There were 70 neoplastic lesions out of which 11 were benign with 6 cavernous hemangiomas, 3 hepatic adenomas and one each of intraductal papillary neoplasm and mucinous cystic neoplasm. Among the 59 malignant lesions, hepatocellular carcinomas predominated followed by metastatic malignancies and cholangiocarcinomas. Of the metastatic malignancies, adenocarcinoma from gastrointestinal primary was the commonest followed by metastatic gastrointestinal stromal tumor.Conclusions: Liver is a frequent site for many neoplastic and non-neoplastic diseases with malignant neoplasms forming the major bulk. Non-neoplastic lesions like simple liver cysts and focal nodular hyperplasia showed female predominance while benign neoplasms like cavernous hemangioma and hepatic adenomas were seen exclusively in females. Of the malignant liver tumors, hepatocellular carcinoma was the commonest followed by metastatic malignancy, gastrointestinal tract being the commonest source of primary tumor.

scholarly journals Mucinous cystic neoplasms of the liver: presence of biliary communication

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Robert M Rodriguez ◽  
Martin Barrio ◽  
Mitch L Parker ◽  
Omer Saeed ◽  
Stuart Sherman ◽  
...  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Diagnostic Workup ◽  
Cystic Neoplasm ◽  
Low Grade ◽  
Liver Mass ◽  
Cystic Neoplasms ◽  
Mucinous Cystic Neoplasms ◽  
Mucinous Epithelium ◽  
Central Hepatectomy ◽  
Biliary Communication

Abstract A 35-year-old woman was referred for a symptomatic liver mass. Diagnostic workup detected a septated cyst located centrally in the liver measuring 10 × 7 cm. The cyst had gradually increased in size from previous studies with new intrahepatic biliary dilation. Due to concern for malignancy and symptomatic presentation of the patient, a partial central hepatectomy was performed. Pathology revealed a smooth-walled, multiloculated cyst lined with mucinous epithelium and ovarian-type stroma. The diagnosis of low-grade mucinous cystic neoplasm of the liver (MCN-L) was made. Characteristics of MCN-L have not been elucidated due to its rarity.

Imaging of Malignant and Benign Tumors of the Pancreas

2018 ◽  
Author(s):  
Ersan Altun ◽  
Richard C Semelka
Keyword(s):  
Neuroendocrine Tumors ◽  
Pancreatic Neoplasms ◽  
Multidetector Ct ◽  
Imaging Techniques ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Benign Tumors ◽  
Imaging Findings ◽  
Cystic Neoplasms ◽  
Cross Sectional

Pancreatic cross-sectional imaging has been widely used to diagnose and stage pancreatic neoplasms. The most commonly used techniques include multidetector CT, MRI, and endoscopic ultrasonography. Hybrid imaging including positron emission tomography combined with CT has a limited role. Dedicated imaging applications of these modalities for the evaluation of pancreatic neoplasms and their accuracies for different neoplasms are summarized in this review. Critical and differential imaging findings of the most common neoplasms of the pancreas, including adenocarcinoma, neuroendocrine tumors, cystic neoplasms, lymphoma, and metastases, emphasizing the most accurate imaging techniques are also discussed. Additionally, the most common mimics of the pancreatic neoplasms and their imaging findings are reviewed. This review contains 32 references, 13 figures, and 5 tables. Key words: adenocarcinoma, CT, EUS, intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, MRI, neuroendocrine tumors, PET-CT, serous cystadenoma

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