scholarly journals Partial Pancreatic Parenchymal Atrophy Is a New Specific Finding to Diagnose Small Pancreatic Cancer (≤10 mm) Including Carcinoma in Situ: Comparison with Localized Benign Main Pancreatic Duct Stenosis Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 445
Author(s):  
Kentaro Yamao ◽  
Mamoru Takenaka ◽  
Rei Ishikawa ◽  
Ayana Okamoto ◽  
Tomohiro Yamazaki ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Main Pancreatic Duct ◽  
Final Analysis ◽  
Kappa Statistics ◽  
Pancreatic Parenchyma ◽  
Ct Findings ◽  
Small Pancreatic Cancer

Background: This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS). Methods: Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics. Results: The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, p < 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, p = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, p = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group. Conclusions: The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS.

scholarly journals A Case Report of Pancreatic Mucin-producing Cystic Tumor with Carcinoma in Situ of the Dilated Main Pancreatic Duct.

1993 ◽  
Vol 26 (3) ◽  
pp. 937-941
Author(s):  
Masaru Takahashi ◽  
Ritsuro Usui ◽  
Shinkichi Watanabe ◽  
Hidenobu Miyakawa ◽  
Tsuyohiko Honda ◽  
...  
Keyword(s):  
Case Report ◽  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Main Pancreatic Duct ◽  
Cystic Tumor

scholarly journals Synchronous gastric cancer and carcinoma in situ of the pancreas detected by SPACE

2021 ◽  
Author(s):  
Masashi Inoue ◽  
Keishi Hakoda ◽  
Hiroyuki Sawada ◽  
Ryuichiro Hotta ◽  
Ichiro Omori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Main Pancreatic Duct ◽  
Case Reports ◽  
Node Dissection ◽  
Synchronous Gastric Cancer

Gastric cancer was diagnosed with dilation of the main pancreatic duct. SPACE revealed adenocarcinoma, total gastrectomy with distal pancreatectomy were underwent. More case reports are needed to determine whether adjuvant chemotherapy is indicated for patients with PCIS and whether the extent of lymph node dissection can be safely reduced.

scholarly journals A Case of Intraductal Papillary Mucinous Tumor with Carcinoma In Situ in Branching Pancreatic Duct Apart from Main Lesion

2004 ◽  
Vol 37 (6) ◽  
pp. 686-691 ◽  
Author(s):  
Kiyokazu Hiwatashi ◽  
Mineo Tabata ◽  
Jun Kadono ◽  
Masahiko Osako ◽  
Hiroshi Shibuya ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Intraductal Papillary Mucinous Tumor ◽  
Mucinous Tumor

scholarly journals A Case of Pancreatic Intraepithelial Neoplasia That Was Difficult to Diagnose Preoperatively

2015 ◽  
Vol 8 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Hiroyuki Ito ◽  
Yoshiaki Kawaguchi ◽  
Yohei Kawashima ◽  
Atsuko Maruno ◽  
Masami Ogawa ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Cystic Lesion ◽  
Precancerous Lesion ◽  
Intraepithelial Neoplasia ◽  
The Body ◽  
Pancreatic Ductal Carcinoma ◽  
Pancreatic Intraepithelial Neoplasia ◽  
Multiple Imaging

A 63-year-old female patient presented to a local physician with pain in her back and epigastric region. An abdominal computed tomography (CT) scan revealed a pancreatic tumor, and the patient was referred to our hospital. Multiple imaging studies that included ultrasonography (US), CT, MRI, and endoscopic US revealed a cystic lesion 3-4 cm in size with node-like projections in the body of the pancreas. The distal main pancreatic duct was also found to be dilated. Endoscopic retrograde pancreatography revealed an irregular stenosis of the main pancreatic duct proximal to the cystic lesion, and malignancy was suspected. The patient was preoperatively diagnosed with pancreatic ductal carcinoma concomitant with intraductal papillary mucinous carcinoma, and a distal pancreatectomy was performed. Rapid pathological diagnosis during surgery revealed positive surgical margins for pancreatic intraepithelial neoplasia (PanIN). Further resection was performed twice, her surgical margin was positive and total pancreatectomy was ultimately conducted. Histopathological findings revealed diffuse microinvasive cancerous lesions corresponding to PanIN-2 (moderate dysplasia) to PanIN-3 (carcinoma in situ) throughout the pancreas. PanIN involves microlesions of the ductal epithelium that may precede pancreatic cancer. Ascertaining changes in PanIN using images provided by diagnostic modalities such as CT and US is challenging. Ductal stenosis and distal cystic lesions resulting from atrophy and fibrosis of pancreatic tissue were noted around PanIN. Considering the possibility of PanIN, a precancerous lesion during differential diagnosis will help to improve early detection and prognosis for patients with pancreatic cancer.

scholarly journals Predictive Value of Localized Stenosis of the Main Pancreatic Duct for Early Detection of Pancreatic Cancer

2019 ◽  
Vol 52 (6) ◽  
pp. 588-597 ◽  
Author(s):  
Yoshihide Kanno ◽  
Shinsuke Koshita ◽  
Takahisa Ogawa ◽  
Hiroaki Kusunose ◽  
Kaori Masu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Early Detection ◽  
Pancreatic Duct ◽  
Predictive Value ◽  
Main Pancreatic Duct ◽  
Localized Stenosis

scholarly journals Focal Parenchymal Atrophy and Fat Replacement Are Clues for Early Diagnosis of Pancreatic Cancer with Abnormalities of the Main Pancreatic Duct

2020 ◽  
Vol 252 (1) ◽  
pp. 63-71
Author(s):  
Shin Miura ◽  
Kiyoshi Kume ◽  
Kazuhiro Kikuta ◽  
Shin Hamada ◽  
Tetsuya Takikawa ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Early Diagnosis ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Fat Replacement

scholarly journals Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer

Diagnostics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 15 ◽  
Author(s):  
Shuzo Terada ◽  
Masataka Kikuyama ◽  
Shinya Kawaguchi ◽  
Hideyuki Kanemoto ◽  
Yoshihiro Yokoi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Endoscopic Ultrasonography ◽  
Invasive Carcinoma ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Tumor Type ◽  
Cytologic Examination ◽  
Small Pancreatic Cancer ◽  
Invasive Carcinomas

Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included. The preoperative EUS findings were classified as follows. A1: Simple stricture type—no findings around the stricture; A2: Hypoecho stricture type—localized hypoechoic area without demarcation around the stricture; A3: Tumor stricture type—tumor on the stricture; B: Dilation type—the dilation of the pancreatic duct without a downstream stricture; C: Parenchymal tumor type—tumor located apart from the MPD. Results: Classes A1 and A2 consisted of 2 CISs, and 4 invasive carcinomas included two cases smaller than 5 mm in diameter. Most of the cancers classified as A3 or C were of invasive carcinoma larger than 5 mm in diameter. All cancers classified as B involved CIS. Serial pancreatic-juice aspiration cytologic examination (SPACE) was selected for all types of cases, with a sensitivity of 92.0%, while EUS-guided fine needle aspiration cytology (EUS-FNA) was only useful for invasive carcinoma, and its sensitivity was 66.7%. Conclusions: Stricture without a tumor could be a finding for invasive PC and pancreatic duct dilation without a downstream stricture could be a finding indicative of CIS. Carcinoma smaller than 5 mm in diameter could not be recognized by EUS. SPACE had a high sensitivity for diagnosing small PC.

scholarly journals Analysis of Progression Time in Pancreatic Cancer including Carcinoma In Situ Based on Magnetic Resonance Cholangiopancreatography Findings

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1858
Author(s):  
Kentaro Yamao ◽  
Masakatsu Tsurusaki ◽  
Kota Takashima ◽  
Hidekazu Tanaka ◽  
Akihiro Yoshida ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Magnetic Resonance ◽  
Natural History ◽  
Rapid Growth ◽  
Carcinoma In Situ ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Tumor Detection ◽  
Time To Diagnosis ◽  
First Time

Background: Pancreatic cancer (PC) exhibits extremely rapid growth; however, it remains largely unknown whether the early stages of PC also exhibit rapid growth speed equivalent to advanced PC. This study aimed to investigate the natural history of early PCs through retrospectively assessing pre-diagnostic images. Methods: We examined the data of nine patients, including three patients with carcinoma in situ (CIS), who had undergone magnetic resonance cholangiopancreatography (MRCP) to detect solitary main pancreatic duct (MPD) stenosis >1 year before definitive PC diagnosis. We retrospectively analyzed the time to diagnosis and first-time tumor detection from the estimated time point of first-time MPD stenosis detection without tumor lesion. Results: The median tumor size at diagnosis and the first-time tumor detection size were 14 and 7.5 mm, respectively. The median time to diagnosis and first-time tumor detection were 26 and 49 months, respectively. Conclusions: No studies have investigated the PC history, especially that of early PCs, including CIS, based on the initial detection of MPD stenosis using MRCP. Assessment of a small number of patients showed that the time to progression can take several years in the early PC stages. Understanding this natural history is very important in the clinical setting.

scholarly journals Efficacy of brush cytology of the main pancreatic duct and biliary duct in the diagnosis of pancreatic cancer

2004 ◽  
Vol 65 (2) ◽  
pp. 47-50
Author(s):  
Takayuki Aimoto ◽  
Takashi Tajiri ◽  
Eiji Uchida ◽  
Yoshiharu Nakamura ◽  
Akira Katsuno ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Biliary Duct ◽  
Brush Cytology
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