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Intraductal pancreatic mucinous neoplasm

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https://www.readbyqxmd.com/read/28079542/development-and-validation-of-a-multi-institutional-preoperative-nomogram-for-predicting-grade-of-dysplasia-in-intraductal-papillary-mucinous-neoplasms-ipmns-of-the-pancreas-a-report-from-the-pancreatic-surgery-consortium
#1
Marc A Attiyeh, Carlos Fernández-Del Castillo, Mohammad Al Efishat, Anne A Eaton, Mithat Gönen, Ruqayyah Batts, Ilaria Pergolini, Neda Rezaee, Keith D Lillemoe, Cristina R Ferrone, Mari Mino-Kenudson, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Previous nomogram models for patients undergoing resection of intraductal papillary mucinous neoplasms (IPMNs) have been relatively small single-institutional series. Our objective was to improve upon these studies by developing and independently validating a new model using a large multiinstitutional dataset. SUMMARY BACKGROUND DATA: IPMNs represent the most common radiographically identifiable precursor lesions of pancreatic cancer. They are a heterogenous group of neoplasms in which more accurate markers of high-grade dysplasia or early invasive carcinoma could help avoid unnecessary surgery in 1 case and support potentially curative intervention (resection) in another...
September 20, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28065885/endoscopic-retrograde-cholangiopancreatography-with-ampullary-biopsy-vs-ercp-alone-a-matched-pairs-controlled-evaluation-of-outcomes-and-complications
#2
Sunil Dacha, Saurabh Chawla, Jai Eun Lee, Steven A Keilin, Qiang Cai, Field F Willingham
BACKGROUND AND AIMS: Biopsy of the ampulla of Vater may be performed to evaluate for ampullary adenomas, suspected ampullary tumors and immunohistological staining for autoimmune pancreatitis. Ampullary biopsies are commonly performed at the time of endoscopic retrograde cholangiopancreatography (ERCP). Due to the well-established complication rate following ERCP, the contribution of ampullary biopsy as a potential independent risk factor would require a controlled comparison. METHODS: A matched-pairs, case-control analysis was performed for patients undergoing ERCP with or without ampullary biopsy...
January 8, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28059943/efficacy-safety-and-outcomes-of-endoscopic-retrograde-cholangiopancreatography-with-per-oral-pancreatoscopy-a-multicenter-experience
#3
Sheeva K Parbhu, Ali A Siddiqui, Megan Murphy, Arish Noor, Linda J Taylor, Alyssa Mills, Douglas G Adler
INTRODUCTION: Per-oral pancreatoscopy can be used for both evaluation and treatment of pancreatic duct stones during endoscopic retrograde cholangiopancreatography, evaluating and treating pancreatic duct strictures of indeterminate etiology, and visual inspection and direct biopsy of pancreatic duct mucosa for diagnosis of intraductal papillary mucinous neoplasm (IPMN). We aim to describe the efficacy, safety, and outcomes of pancreatoscopy in a large, multicenter series of patients...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28055239/the-evolving-role-of-pathology-in-new-developments-classification-terminology-and-diagnosis-of-pancreatobiliary-neoplasms
#4
Michelle D Reid, Melinda M Lewis, Field F Willingham, Volkan Adsay
Pancreatobiliary tract lesions are increasingly being discovered because of more sensitive imaging modalities. Magnetic resonance imaging has identified incidental pancreatic cysts in 13.5% of patients of progressively increasing age. Pancreatobiliary tissue is more accessible through endoscopic ultrasound and magnetic resonance imaging-guided biopsy procedures, and is now an integral part of pathologists' routine practice. Accordingly, several new tumor categories have been recently recognized, including intraductal tubulopapillary neoplasm, a new addition to tumoral intraepithelial neoplasms...
January 5, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28054178/hemosuccus-pancreaticus-caused-by-a-mucinous-cystic-neoplasm-of-the-pancreas
#5
Yuri Matsumoto, Hiroshi Miyamoto, Akira Fukuya, Fumika Nakamura, Takahiro Goji, Shinji Kitamura, Tetsuo Kimura, Koichi Okamoto, Masahiro Sogabe, Naoki Muguruma, Mitsuo Shimada, Yoshimi Bando, Tetsuji Takayama
Hemosuccus pancreaticus is a gastrointestinal hemorrhage through the main pancreatic duct. Here, we report a rare case of hemosuccus pancreaticus due to a mucinous cystic neoplasm of the pancreas. A 62-year-old woman who had been followed for a branch duct intraductal papillary mucinous neoplasm visited our emergency room due to severe abdominal pain and bloody discharge. Computed tomography revealed that the pancreatic cyst increased the tension of the wall and a high-density area indicative of bleeding into the cyst was observed...
January 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28030856/criteria-for-determining-malignancy-in-pancreatic-intraductal-papillary-mucinous-neoplasm-based-on-computed-tomography
#6
Peter Mönnings, Orlin Belyaev, Waldemar Uhl, Arnd Giese, Andrea Tannapfel, Odo Köster, Juris J Meier
INTRODUCTION: Determining the dignity of intraductal papillary mucinous neoplasms (IPMNs) by imaging procedures is challenging. Various CT-based criteria were evaluated. PATIENTS AND METHODS: Preoperative CT scans from 47 patients with IPMN were analyzed. Predefined criteria of malignancy were compared between patients with benign (bIPMN; n = 28) and malignant (mIPMN; n = 19) tumors, and a summation score was determined. RESULTS: Preoperative carbohydrate-antigen 19-9 levels were higher in patients with mIPMN (p = 0...
December 29, 2016: Digestion
https://www.readbyqxmd.com/read/28011509/technical-feasibility-and-oncological-legitimacy-of-enucleation-of-intraductal-papillary-mucinous-neoplasm-located-at-the-pancreatic-head-or-uncinate-process
#7
Yuji Soejima, Takeo Toshima, Takashi Motomura, Tomoyuki Yokota, Kouji Joko, Yumi Oshiro, Ikuo Takahashi, Takashi Nishizaki, Yoshihiko Maehara
BACKGROUND: Surgical indications and strategies for branch duct (BD)-intraductal papillary mucinous neoplasm (IPMN) at the pancreatic head (PH) are controversial issues. We investigated the technical feasibility and oncological legitimacy of enucleation for IPMN of the PH. PATIENTS AND METHODS: The clinicopathological parameters of 11 patients with IPMN who underwent conventional pancreaticoduodenectomy (PD, n=7) or enucleation (n=4) during the same period were evaluated...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/28002329/incidental-pancreatic-cystic-neoplasms-in-an-asymptomatic-healthy-population-of-21-745-individuals-large-scale-single-center-cohort-study
#8
Ye Rim Chang, Joo Kyung Park, Jin-Young Jang, Wooil Kwon, Jeong Hee Yoon, Sun-Whe Kim
Although incidental pancreatic cystic neoplasms are being diagnosed with increasing frequency, little is known about the accurate prevalence of pancreatic cysts in the general population. The aims of this study were to evaluate the crude prevalence rate of pancreatic cystic neoplasms in asymptomatic healthy adults, and calculate the age- and sex-adjusted nationwide prevalence rate.A total of 21,745 asymptomatic individuals who underwent abdominal computed tomography (CT) as a health screening examination were enrolled between 2003 and 2013 at the Seoul National University Hospital Healthcare System Gangnam Center...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28000629/effectiveness-of-contrast-enhanced-endoscopic-ultrasound-for-detecting-mural-nodules-in-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-and-for-making-therapeutic-decisions
#9
Mitsuru Fujita, Takao Itoi, Nobuhito Ikeuchi, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Kentaro Kamada, Junko Umeda, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Fuminori Moriyasu
BACKGROUND AND OBJECTIVES: There have been few studies to date evaluating the effectiveness of contrast-enhanced endoscopic ultrasound (CE-EUS) for detecting mural nodules in patients with branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas. We aim to evaluate the effectiveness of CE-EUS for detecting mural nodules in BD-IPMN. PATIENTS AND METHODS: Of the 427 BD-IPMN patients, 21 patients (4.9%) in whom the presence of mural nodules was suggested by CE computed tomography (CT) or magnetic resonance imaging (MRI), or in whom the presence of nodule-like lesions as shown by fundamental EUS, were examined by CE-EUS...
November 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27992432/a-gastric-glycoform-of-muc5ac-is-a-biomarker-of-mucinous-cysts-of-the-pancreas
#10
Jessica Sinha, Zheng Cao, Jianliang Dai, Huiyuan Tang, Katie Partyka, Galen Hostetter, Diane M Simeone, Ziding Feng, Peter J Allen, Randall E Brand, Brian B Haab
Molecular indicators to specify the risk posed by a pancreatic cyst would benefit patients. Previously we showed that most cancer-precursor cysts, termed mucinous cysts, produce abnormal glycoforms of the proteins MUC5AC and endorepellin. Here we sought to validate the glycoforms as a biomarker of mucinous cysts and to specify the oligosaccharide linkages that characterize MUC5AC. We hypothesized that mucinous cysts secrete MUC5AC displaying terminal N-acetylglucosamine (GlcNAc) in either alpha or beta linkage...
2016: PloS One
https://www.readbyqxmd.com/read/27984235/intraductal-tubulopapillary-neoplasm-of-the-pancreas-a-clinicopathologic-and-immunohistochemical-analysis-of-33-cases
#11
Olca Basturk, Volkan Adsay, Gokce Askan, Deepti Dhall, Giuseppe Zamboni, Michio Shimizu, Karina Cymes, Fatima Carneiro, Serdar Balci, Carlie Sigel, Michelle D Reid, Irene Esposito, Helena Baldaia, Peter Allen, Günter Klöppel, David S Klimstra
Intraductal tubulopapillary neoplasm (ITPN) is a relatively recently described member of the pancreatic intraductal neoplasm family. Thus, the literature on its histologic and immunohistochemical features, clinical behavior, and its similarities and differences from other pancreatic neoplasms is limited. Thirty-three cases of ITPN, the largest series to date, were identified. Immunohistochemical labeling for cytokeratins, glycoproteins, pancreatic enzymes, markers for intestinal and neuroendocrine differentiation, and antibodies associated with genetic alterations previously described in pancreatic neoplasms was performed...
December 14, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27981313/a-case-of-serous-cystadenoma-communicating-with-a-stenotic-santorini-s-duct-and-a-dilated-main-pancreatic-duct
#12
Hiroyuki Matsubayashi, Yurika Oka, Takaaki Ito, Katsuhiko Uesaka, Keiko Sasaki, Hiroyuki Ono
A 59-year-old woman was referred for investigation of a pancreatic cystic lesion. Computed tomography revealed a well-demarcated, multilocular cyst, approximately 4 cm in size, at the pancreas head. Endoscopic ultrasonography demonstrated honeycomb-like components at the cyst margin. The cyst was associated with a widely-dilated upstream main pancreatic duct (MPD). Endoscopic retrograde pancreatography demonstrated a communication between the stenotic Santorini's duct and the cyst. Aspiration cytology from the cyst demonstrated clusters of mucinous epithelial neoplasm cells...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27977634/kras-mutations-with-no-gnas-mutations-in-an-intraductal-papillary-mucinous-neoplasm-are-there-common-pathways-with-pancreatic-ductal-adenocarcinoma-lessons-from-an-extended-ipmn-covering-the-entire-pancreas
#13
Athanasios Tampakis, Ekaterini Chistina Tampaki, Alberto Posabella, Andreas Zettl, Gregory Kouraklis, Markus von Flüe, Marc Oliver Guenin
No abstract text is available yet for this article.
January 2017: Pancreas
https://www.readbyqxmd.com/read/27926366/analysis-of-pancreatic-cyst-fluid
#14
REVIEW
Saowanee Ngamruengphong, Anne Marie Lennon
Pancreatic cysts are extremely common, and are identified in between 2% to 13% on abdominal imaging studies. Most pancreatic cysts are pseudocysts, serous cystic neoplasms, mucinous cystic neoplasms, or intraductal papillary mucinous neoplasms. The management of pancreatic cysts depends on whether a cyst is benign, has malignant potential, or harbors high-grade dysplasia or invasive carcinoma. The diagnosis of pancreatic cysts, and assessment of risk of malignant transformation, incorporates clinical history, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound, and fine-needle aspiration of cyst fluid...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27926360/pathology-of-pancreatic-cancer-precursor-lesions
#15
REVIEW
Michaël Noë, Lodewijk A A Brosens
To better understand pancreatic ductal adenocarcinoma (PDAC) and improve its prognosis, it is essential to understand its origins. This article describes the pathology of the 3 well-established pancreatic cancer precursor lesions: pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm. Each of these precursor lesions has unique clinical findings, gross and microscopic features, and molecular aberrations. This article focuses on histopathologic diagnostic criteria and reporting guidelines...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27920477/evolution-of-incidental-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-a-study-with-magnetic-resonance-imaging-cholangiopancreatography
#16
Rossano Girometti, Riccardo Pravisani, Sergio Giuseppe Intini, Miriam Isola, Lorenzo Cereser, Andrea Risaliti, Chiara Zuiani
AIM: To investigate the type and timing of evolution of incidentally found branch-duct intraductal papillary mucinous neoplasms (bd-IPMN) of the pancreas addressed to magnetic resonance imaging cholangiopancreatography (MRCP) follow-up. METHODS: We retrospectively evaluated 72 patients who underwent, over the period 2006-2016, a total of 318 MRCPs (mean 4.4) to follow-up incidental, presumed bd-IPMN without signs of malignancy, found or confirmed at a baseline MRCP examination...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27902614/associating-pancreaticostomy-and-biliary-irrigation-for-staged-pancreaticoduodenectomy-approach-to-pancreatic-intraductal-papillary-mucinous-neoplasm-with-recurrent-cholangitis-and-severe-jaundice-a-case-report
#17
Chao Dai, Siyuan Lou, Fan Zhou
PATIENT CONCERNS: A 63-year-old man was hospitalized with history of abdominal pain since more than 1 year, and that of fever with chills since 2 weeks. DIAGNOSES: Based on the laboratory investigations and radiologic findings, a preliminary diagnosis of pancreatic intraductal papillary mucinous neoplasm (IPMN) with recurrent cholangitis and severe jaundice was made. INTERVENTIONS: An initial attempt at endoscopic and image-guided drainage proved unsuccessful...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900458/utility-of-whole-lesion-adc-histogram-metrics-for-assessing-the-malignant-potential-of-pancreatic-intraductal-papillary-mucinous-neoplasms-ipmns
#18
David H Hoffman, Justin M Ream, Christina H Hajdu, Andrew B Rosenkrantz
PURPOSE: To evaluate whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs), including in comparison with conventional MRI features. METHODS: Eighteen branch-duct IPMNs underwent MRI with DWI prior to resection (n = 16) or FNA (n = 2). A blinded radiologist placed 3D volumes-of-interest on the entire IPMN on the ADC map, from which whole-lesion histogram metrics were generated. The reader also assessed IPMN size, mural nodularity, and adjacent main-duct dilation...
November 30, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27889759/cytomorphological-features-useful-to-prevent-errors-in-the-diagnosis-of-pancreatic-adenocarcinoma-by-fine-needle-aspiration-cytology
#19
Zhikai Chi, Howard H Wu, Harvey Cramer, Jingmei Lin, Shaoxiong Chen
OBJECTIVES: Endoscopic ultrasound-guided fine-needle aspiration (FNA) is now widely used as a primary tool to diagnose pancreatic neoplasms. However, criteria that can reduce the risk of overdiagnosing pancreatic adenocarcinoma by FNA have not been adequately defined in the literature. This study aims to identify characteristic cytomorphological features that are helpful in distinguishing pancreatic adenocarcinoma from its mimics. STUDY DESIGN: Five false-positive FNA cases (group A) diagnosed as adenocarcinoma (4 cases) and suspicious for adenocarcinoma (1 case) by FNA, were identified by searching our laboratory information system...
November 26, 2016: Acta Cytologica
https://www.readbyqxmd.com/read/27884612/enucleation-a-treatment-alternative-for-branch-duct-intraductal-papillary-mucinous-neoplasms
#20
Joerg Kaiser, Stefan Fritz, Miriam Klauss, Frank Bergmann, Ulf Hinz, Oliver Strobel, Lutz Schneider, Markus W Büchler, Thilo Hackert
BACKGROUND: Small, asymptomatic, branch-duct intraductal papillary mucinous neoplasms of the pancreas are often kept under surveillance despite their malignant potential. The management of branch-duct intraductal papillary mucinous neoplasm is controversial with regard to indications and extent of any operative intervention. The present study aimed to evaluate enucleation as an alternative operative approach for branch-duct intraductal papillary mucinous neoplasms to exclude and prevent malignancy...
November 21, 2016: Surgery
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