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Pancreatic mucinous cystic neoplasm

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https://www.readbyqxmd.com/read/28528374/pancreatic-cysts-and-guidelines
#1
REVIEW
James J Farrell
Pancreatic cysts, especially incidental asymptomatic ones seen on noninvasive imaging such as CT or MR imaging, remain a clinical challenge. The etiology of such cysts may range from benign cysts without any malignant potential such as pancreatic pseudocysts and serous cystadenomas to premalignant or frankly malignant cysts such as mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, cystic degeneration associated with solid tumors such as pancreatic ductal adenocarcinoma or pancreatic endocrine neoplasms, and solid pseudopapillary neoplasms...
May 20, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28511236/long-term-outcomes-after-endoscopic-ultrasound-guided-ablation-of-pancreatic-cysts
#2
Jun-Ho Choi, Dong Wan Seo, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Sung Koo Lee, Myung-Hwan Kim
Background and study aims The aim of this study was to investigate the long-term outcomes after endoscopic ultrasound (EUS)-guided pancreatic cyst ablation. Patients and methods In a single-center, prospective study, 164 patients with pancreatic cysts underwent EUS-guided cyst ablation using ethanol with paclitaxel. The inclusion criteria were as follows: unilocular or oligolocular cysts; clinically indeterminate cysts that required EUS fine-needle aspiration; and/or cysts that grew during the observation period...
May 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/28500587/insights-into-the-pathogenesis-of-pancreatic-cystic-neoplasms
#3
REVIEW
Vrishketan Sethi, Bhuwan Giri, Ashok Saluja, Vikas Dudeja
With the current epidemic of diagnosed pancreatic cystic neoplasms on the rise, a substantial amount of work has been done to unravel their biology, thus leading to implications on clinical decision making. Recent genetic profiling of resected human specimens has identified alterations in signaling pathways involving KRAS and GNAS signaling as early events in the pathogenesis of intraductal pancreatic mucinous neoplasms. Progressively, mutations in genes such as TP53, SMAD4, RNF43, and others are thought to characterize invasive and advanced lesions...
May 12, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28463669/pancreatic-cystic-lesions-diagnostic-management-and-indications-for-operation-part-i
#4
Ferdinand Bauer
We notice an increasing frequency in the detection and evaluation of pancreatic cystic lesions (PCLs) over the last three decades. They show awide spectrum of imaging and clinical features. The diagnosis and discrimination of these lesions are very important because of the risk for concurrent or later development of malignancy. The main reason is the increased awareness of these lesions and the extensive use of cross-sectional imaging, an always improving technique (1). Commonly, PCLs are diagnosed incidentally during investigation for often unrelated and nonspecific abdominal complaints using state-of-the art abdominal imaging (CT, MRT)...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28444494/imaging-of-pancreatic-cystic-lesions-with-confocal-laser-endomicroscopy-an-ex-vivo-pilot-study
#5
Abdurrahman Kadayifci, Mustafa Atar, Michelle Yang, Carlos Fernandez-Del Castillo, Mari Mino-Kenudson, William R Brugge
BACKGROUND: The differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE. METHODS: Patients who underwent surgery of a PCL were enrolled...
April 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28440237/new-criteria-to-differentiate-between-mucinous-cystic-neoplasm-and-serous-cystic-neoplasm-in-pancreas-by-endoscopic-ultrasound-a-preliminarily-confirmed-outcome-of-41-patients
#6
Wengang Zhang, Enqiang Linghu, Ningli Chai, Huikai Li
BACKGROUND AND OBJECTIVES: The ability to distinguish between mucinous cystic neoplasm (MCN) and serous cystic neoplasm (SCN) in the pancreas preoperatively by endoscopic ultrasound (EUS) remains a clinical challenge. To address this problem, we have developed new criteria using EUS findings and cyst fluid carcinoembryonic antigen (CEA) in the clinic. In this study, the validity and reliability of these criteria were assessed. MATERIALS AND METHODS: Between April of 2015 and May of 2016, a total of 59 patients with pancreatic cystic neoplasms underwent EUS and ultimately received surgery in our hospital...
March 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28421458/surgical-management-of-pancreatic-cysts-a-shifting-paradigm-toward-selective-resection
#7
REVIEW
Jon M Gerry, George A Poultsides
Due to the widespread use of high-quality cross-sectional imaging, pancreatic cystic neoplasms are being diagnosed with increasing frequency. Clinicians are therefore asked to counsel a growing number of patients with pancreatic cysts diagnosed incidentally at an early, asymptomatic stage. Over the last two decades, accumulating knowledge on the biologic behavior of these neoplasms along with improved diagnostics through imaging and endoscopic cyst fluid analysis have allowed for a selective therapeutic approach toward these neoplasms...
April 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28416122/patients-with-a-resected-pancreatic-mucinous-cystic-neoplasm-have-a-better-prognosis-than-patients-with-an-intraductal-papillary-mucinous-neoplasm-a-large-single-institution-series
#8
James F Griffin, Andrew J Page, Georges J Samaha, Adrienne Christopher, Feriyl Bhaijee, Maryam K Pezhouh, Niek A Peters, Ralph H Hruban, Jin He, Martin A Makary, Anne Marie Lennon, John L Cameron, Christopher L Wolfgang, Matthew J Weiss
BACKGROUND/OBJECTIVES: Mucinous cystic neoplasms (MCNs) are rare pancreas tumors distinguished from intraductal papillary mucinous neoplasms (IPMNs) by the presence of ovarian-type stroma. Historical outcomes for MCNs vary due to previously ambiguous diagnostic criteria resulting in confusion with IPMNs. This study seeks to characterize and clarify the clinical features and long-term outcomes of MCNs versus IPMNs in the largest single-institution series of pathology-confirmed MCNs to date...
April 11, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28413390/a-serous-cystic-neoplasm-of-the-pancreas-coexisting-with-high-grade-pancreatic-intraepithelial-neoplasia-mimicking-an-intraepithelial-papillary-mucinous-neoplasm-a-case-report
#9
Aya Kawanishi, Kenichi Hirabayashi, Hirotaka Kono, Yumi Takanashi, Atsuko Hadano, Yohei Kawashima, Masami Ogawa, Yoshiaki Kawaguchi, Misuzu Yamada, Toshio Nakagohri, Naoya Nakamura, Tetsuya Mine
Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#10
REVIEW
Aatur D Singhi, Marina N Nikiforova, Kevin McGrath
Pancreatic cysts are a clinical quandary in both diagnosis and management. Although many cysts, such as pseudocysts and serous cystadenomas, are benign and can be monitored clinically, mucinous cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic cancer. Considering the poor prognosis of pancreatic cancer, the detection of a pancreatic cyst can be a source of anxiety for both the patient and physician. This diagnosis in turn can lead to expensive, invasive, and even harmful surveillance and treatment options...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396777/pancreatic-pseudocyst-or-mucinous-cystadenocarcinoma-of-pancreas-a-diagnostic-dilemma
#11
Utsav Joshi, Prakash Poudel, Ram Kumar Ghimire, Babin Basnet
Pancreatic cystic neoplasm is difficult to distinguish from pseudocyst as clinical and radiological evidences may not be sufficient to make an accurate diagnosis. This may result in misdiagnosis with inappropriate management. Hence, every effort should be made for their distinction to avoid internal drainage procedures for neoplasms instead of extirpation.
April 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28390868/small-nucleolar-noncoding-rna-snora23-upregulated-in-human-pancreatic-ductal-adenocarcinoma-regulates-expression-of-syne2-to-promote-growth-and-metastasis-of-xenograft-tumors-in-mice
#12
Lin Cui, Kenji Nakano, Sumalee Obchoei, Kiyoko Setoguchi, Masaki Matsumoto, Tsuyoshi Yamamoto, Satoshi Obika, Kazuaki Shimada, Nobuyoshi Hiraoka
BACKGROUND & AIMS: Small nucleolar noncoding RNAs (snoRNAs) regulate function of ribosomes, and specific snoRNAs are dysregulated in some cancer cells. We investigated dysregulation of snoRNAs in pancreatic ductal adenocarcinoma (PDAC) cells. METHODS: We investigated snoRNA expression in PDAC cell lines by cDNA microarray and quantitative reverse transcription (qRT)-PCR. In PDAC (n=133), intraductal papillary mucinous neoplasm (IPMN, n=16), mucinous cystic neoplasm-associated PDAC (n=1), and non-tumor pancreas (n=8) and liver (n=3) tissues from subjects who underwent surgical resection, levels of snoRNA were measured by qRT-PCR and compared with clinicopathological parameters and survival times determined by Kaplan Meier analysis...
April 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28383565/diversity-of-precursor-lesions-for-pancreatic-cancer-the-genetics-and-biology-of-intraductal-papillary-mucinous-neoplasm
#13
Krushna C Patra, Nabeel Bardeesy, Yusuke Mizukami
Pancreatic ductal adenocarcinoma (PDA), one of the most lethal cancers worldwide, is associated with two main types of morphologically distinct precursors-pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). Although the progression of PanIN into invasive cancer has been well characterized, there remains an urgent need to understand the biology of IPMNs, which are larger radiographically detectable cystic tumors. IPMNs comprise a number of subtypes with heterogeneous histopathologic and clinical features...
April 6, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28374746/intracellular-hmgb1-as-a-novel-tumor-suppressor-of-pancreatic-cancer
#14
Rui Kang, Yangchun Xie, Qiuhong Zhang, Wen Hou, Qingping Jiang, Shan Zhu, Jinbao Liu, Dexing Zeng, Haichao Wang, David L Bartlett, Timothy R Billiar, Herbert J Zeh, Michael T Lotze, Daolin Tang
Pancreatic ductal adenocarcinoma (PDAC) driven by oncogenic K-Ras remains among the most lethal human cancers despite recent advances in modern medicine. The pathogenesis of PDAC is partly attributable to intrinsic chromosome instability and extrinsic inflammation activation. However, the molecular link between these two events in pancreatic tumorigenesis has not yet been fully established. Here, we show that intracellular high mobility group box 1 (HMGB1) remarkably suppresses oncogenic K-Ras-driven pancreatic tumorigenesis by inhibiting chromosome instability-mediated pro-inflammatory nucleosome release...
April 4, 2017: Cell Research
https://www.readbyqxmd.com/read/28371566/cytologic-features-and-clinical-implications-of-undifferentiated-carcinoma-with-osteoclastic-giant-cells-of-the-pancreas-an-analysis-of-15-cases
#15
Michelle D Reid, Takashi Muraki, Kim HooKim, Bahar Memis, Rondell P Graham, Daniela Allende, Jiaqi Shi, David F Schaeffer, Remmi Singh, Olca Basturk, Volkan Adsay
BACKGROUND: The cytologic features of undifferentiated pancreatic carcinoma with osteoclastic giant cells (UOC) are rarely described. METHODS: Cytologic and clinicopathologic characteristics in 15 UOC fine-needle aspiration (FNA) specimens were analyzed. RESULTS: FNA specimens were obtained from 6 men and 8 women with a mean age of 65 years who had UOCs (head, n = 7; body, n = 3; and tail, n = 4) with a mean radiologic size 7.3 cm, and some had a cystic component (n = 9)...
April 3, 2017: Cancer
https://www.readbyqxmd.com/read/28343174/mirna-analysis-in-pancreatic-cancer-the-dartmouth-experience
#16
REVIEW
Francine B de Abreu, Xiaoying Liu, Gregory J Tsongalis
Pancreatic cancer is considered one of the most lethal cancers being the fourth leading cause of cancer deaths in adults in the United States because of the lack of early signs and symptoms and the lack of early detection. Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type among pancreatic cancers, representing 80%-90% of all solid tumors of the pancreas. The majority of PDAC develops from three precursor lesions: pancreatic intraepithelial neoplasia, intraductual papillary mucinous neoplasm and mucinous cystic neoplasm...
May 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#17
Yusuke Takahashi, Naoyuki Yokoyama, Daisuke Sato, Tetsuya Otani, Koko Mitsuma, Hideki Hashidate
INTRODUCTION: Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE: A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening...
March 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28260136/cells-of-origin-of-pancreatic-neoplasms
#18
REVIEW
Junpei Yamaguchi, Yukihiro Yokoyama, Toshio Kokuryo, Tomoki Ebata, Masato Nagino
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignant disease associated with poor prognosis, despite recent medical advances. It is of great importance to understand the initial events and cells of origin of pancreatic cancer to prevent the development and progression of PDAC. There are three distinct precursor lesions that develop into PDAC: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs). Studies on genetically engineered mouse models have revealed that the initiation and development of these lesions largely depend on genetic alterations...
March 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28258561/a-resected-case-of-two-branch-duct-type-intraductal-papillary-mucinous-neoplasms-showing-different-clinical-courses-after-a-two-year-follow-up
#19
Hideki Shibata, Nobuyuki Ohike, Tomoko Norose, Tomohide Isobe, Reika Suzuki, Hideyuki Imai, Akira Shiokawa, Masafumi Takimoto, Akihiro Tabuchi, Yuichi Takano, Eiichi Yamamura, Masatsugu Nagahama, Nobuyuki Takeyama, Kazuaki Yokomizo, Hiroki Mizukami, Jun-Ichi Tanaka, Takeshi Aoki, Masahiko Murakami
The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN (b), 16 mm in size] and tail [BD-IPMN (t), 13 mm in size] without a "high-risk stigmata" or "worrisome features". He subsequently received follow-up by MRCP every 6 months...
June 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28255733/natural-courses-of-branch-duct-intraductal-papillary-mucinous-neoplasm
#20
Taeheon Lee, Hong Joo Kim, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi
PURPOSE: The study was done to elucidate the clinico-radiologic predictive factors for cancerous change detected by disease progression (PD) mainly defined by interval increase in cyst size and change of cyst morphology, for branch duct intraductal papillary mucinous neoplasm (BD-IPMN) patients with relatively long-term follow-up. METHODS: Retrospective analysis of medical records and imaging findings were performed on 107 patients with BD-IPMN enrolled from July 2005 to May 2013, in whom the communication between the cystic lesion and pancreatic duct was confirmed by either endoscopic ultrasonography (EUS), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP)...
May 2017: Langenbeck's Archives of Surgery
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