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Mucinous pancreatic cyst

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https://www.readbyqxmd.com/read/28424202/global-protease-activity-profiling-provides-differential-diagnosis-of-pancreatic-cysts
#1
Sam L Ivry, Jeremy M Sharib, Dana A Dominguez, Nilotpal Roy, Stacy E Hatcher, Michele Yip-Schneider, C Max Schmidt, Randall E Brand, Walter G Park, Matthias Hebrok, Grace Kim, Anthony J O'Donoghue, Kimberly S Kirkwood, Charles S Craik
Pancreatic cysts are estimated to be present 2-3% of the adult population. Unfortunately, current diagnostics do not accurately distinguish benign cysts from those that can progress into invasive cancer. Missregulated pericellular proteolysis is a hallmark of malignancy, and therefore, we used a global approach to discover protease activities that differentiate benign nonmucinous cysts from premalignant mucinous cysts.<br /><br />Experimental Design: We employed an unbiased and global protease profiling approach to discover protease activities in 23 cyst fluid samples...
April 19, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28421458/surgical-management-of-pancreatic-cysts-a-shifting-paradigm-toward-selective-resection
#2
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/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#3
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/28358122/differentiation-of-pancreatic-cyst-types-by-analysis-of-rheological-behavior-of-pancreatic-cyst-fluid
#4
Iyad Khamaysi, Aiman Abu Ammar, Gleb Vasilyev, Arkadii Arinstein, Yehuda Chowers, Eyal Zussman
Differentiation between mucinous and non-mucinous pancreatic cysts is exceedingly important and challenging, particularly as the former bears malignant transformation potential. Pancreatic cyst fluid (PCF)-based diagnostics, including analyses of biochemical markers, as well as cytology, has shown inadequate accuracy. Herein, a preliminary single-center study of 22 PCF samples, collected by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), assessed the rheological behavior of PCF and its correlation with lesion type...
March 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28315508/tumor-markers-in-pancreatic-cystic-fluids-for-diagnosis-of-malignant-cysts
#5
Alexandre Levy, Theodora Popovici, Phuong-Nhi Bories
BACKGROUND AND AIM: Early diagnosis of premalignant or malignant pancreatic cysts is essential to improve prognosis. Sampling of pancreatic cyst fluid by fine-needle aspiration during endoscopic ultrasonography (EUS) enables cytopathological examination combined with biochemical analysis. This study aimed to provide an aid based on biological markers for the preoperative management of patients with pancreatic cysts. METHODS: Pancreatic fluids obtained by EUS-guided fine-needle aspiration from 115 patients with cystic lesions were assayed for amylase, lipase, carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4...
March 3, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28281482/laparoscopic-spleen-preserving-distal-pancreatectomy-for-a-primary-hydatid-cyst-mimicking-a-mucinous-cystic-neoplasia
#6
Tugan Tezcaner, Yahya Ekici, Onur Huseyin Aydın, Gonca Barit, Gökhan Moray
Pancreatic hydatid cysts are fairly rare. The disease can be encountered concurrently with systemic involvement or as an isolated pancreatic involvement. We report the first case of spleen-preserving laparoscopic distal pancreatectomy for a pancreatic hydatid cyst. There was no complication or recurrence. A 55-year-old woman was admitted to our centre with epigastric and back pain. Upper abdominal magnetic resonance imaging revealed a solitary cystic lesion with septations at the pancreatic tail level measuring 24 mm × 18 mm, which was initially thought to be a pancreatic mucinous cystic neoplasia...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#7
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/28258561/a-resected-case-of-two-branch-duct-type-intraductal-papillary-mucinous-neoplasms-showing-different-clinical-courses-after-a-two-year-follow-up
#8
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...
March 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28255733/natural-courses-of-branch-duct-intraductal-papillary-mucinous-neoplasm
#9
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)...
March 2, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28247770/agenesis-of-the-dorsal-pancreas-associated-with-mucinous-cysts-and-chronic-calcific-non-alcoholic-pancreatitis
#10
Javier A Cienfuegos, Alberto Benito, Fernando Rotellar
Agenesis of the dorsal pancreas is a rare malformation. Since 1911 and until 2008, 107 cases have been reported. Herein we report a new case on agenesis of the dorsal pancreas associated with mucinous is and chronic calcific non-alcoholic pancreatitis.
March 1, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28246486/pancreatic-endometrial-cyst-mimics-mucinous-cystic-neoplasm-of-the-pancreas
#11
Michael A Mederos, Nicole Villafañe, Sadhna Dhingra, Carlos Farinas, Amy McElhany, William E Fisher, George Van Buren Ii
Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28244498/active-surveillance-beyond-5-years-is-required-for-presumed-branch-duct-intraductal-papillary-mucinous-neoplasms-undergoing-non-operative-management
#12
Stefano Crippa, Raffaele Pezzilli, Massimiliano Bissolati, Gabriele Capurso, Luigi Romano, Maria Paola Brunori, Lucia Calculli, Domenico Tamburrino, Alessandra Piccioli, Giacomo Ruffo, Gianfranco Delle Fave, Massimo Falconi
OBJECTIVES: To evaluate the results of active surveillance beyond 5 years in patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) without worrisome features (WF) and high-risk stigmata (HRS) undergoing non-operative management. METHODS: Patients with a minimum follow-up of 5 years who underwent surveillance with at least yearly magnetic resonance imaging were included. New onset of and predictors of WF/HRS during follow-up as well as long-term survival were analyzed...
February 28, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28220262/imaging-pancreatic-cysts-with-ct-and-mri
#13
REVIEW
R Brooke Jeffrey
CT and MRI are the imaging modalities of choice to guide the clinical management of incidentally discovered pancreatic cysts. Most of these lesions are mucinous cysts with varying degrees of malignant potential. This article reviews the CT and MRI findings that help differentiate a potentially aggressive lesion that requires EUS or surgery from a lesion of low malignant potential that is appropriate for imaging surveillance. The imaging-based societal guidelines for these cysts are reviewed.
February 20, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28197897/middle-segment-preserving-pancreatectomy-for-metachronous-intraductal-papillary-mucinous-neoplasm-after-pancreatoduodenectomy-a-case-report
#14
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients' quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28196017/endoscopic-ultrasonography-may-select-subjects-having-asymptomatic-chronic-pancreatic-hyperenzymemia-who-require-a-stricter-follow-up
#15
Filippo Antonini, Valerio Belfiori, Nico Pagano, Elisabetta Buscarini, Samuele De Minicis, Massimiliano Lo Cascio, Barbara Marraccini, Simona Piergallini, Pamela Rossetti, Elena Andrenacci, Giampiero Macarri, Raffaele Pezzilli
OBJECTIVES: We have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging techniques. The aim of this study was to evaluate whether EUS may modify the management of patients having ACPH. METHODS: In 2 referral centers for pancreatic disease, a retrospective analysis of prospectively enrolled patients with ACPH was conducted...
April 2017: Pancreas
https://www.readbyqxmd.com/read/28196015/genomic-characterization-of-low-and-high-grade-pancreatic-mucinous-cystic-neoplasms-reveals-recurrent-kras-alterations-in-high-risk-lesions
#16
James R Conner, Adrián Mariño-Enríquez, Mari Mino-Kenudson, Elizabeth Garcia, Martha B Pitman, Lynette M Sholl, Amitabh Srivastava, Leona A Doyle
OBJECTIVES: Pancreatic ductal adenocarcinoma arises from the following 3 distinct precursor lesions: pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm (MCN). Genetic abnormalities in the first 2 precursor lesions have been well characterized, but there are limited data on progression pathways in MCNs. This study aimed to characterize genomic differences between MCNs with low-grade (LG) and high-grade (HG) dysplasia or carcinoma...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28185442/the-role-of-ancillary-tests-in-the-evaluation-and-management-of-patients-with-negative-and-non-diagnostic-pancreatic-cyst-aspirates
#17
Suzanne M Selvaggi
BACKGROUND: Fine needle aspiration of pancreatic cystic lesions has its limitations as the cytology is often paucicellular to acellular. This study reports on the value of ancillary tests, amylase and carcinoembryonic, in the evaluation and management of patients with negative and non-diagnostic pancreatic cysts. METHODS: From January 1, 2010 through December 31, 2015, the Cytopathology Laboratory processed 119 pancreatic cyst aspirates of which 51(43%) were negative and 52(44%) were non-diagnostic and form the basis of this study...
April 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28133201/-long-term-survival-in-response-to-multimodality-therapy-in-a-patient-with-invasive-pancreatic-cancer-with-cyst-formation
#18
Hironobu Makino, Hisashi Kametaka, Tadaomi Fukada, Kazuhiro Seike, Akio Hasegawa, Masaru Isozaki
The patient was a 61-year-old man. Computed tomography(CT)in April 2007 revealed a pancreatic cyst in the tail of the pancreas. Rapid enlargement was noted in November 2007, and the patient was referred to the surgery department. CT showed a cystic lesion containing a nodular shadow in the pancreatic tail. Tumor marker measurements yielded normal carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels, but the duke pancreatic monoclonal antigen type 2(DUPAN-2)level was elevated. A diagnosis of mucinous cystic neoplasm(MCN)of the pancreas was made in December 2007, and distal pancreatectomy and partial colectomy were performed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131667/blood-fibrinogen-levels-discriminate-low-and-high-risk-intraductal-papillary-mucinous-neoplasms-ipmns
#19
M F Nentwich, K Menzel, M Reeh, F G Uzunoglu, T Ghadban, K Bachmann, J Schrader, M Bockhorn, J R Izbicki, D Perez
BACKROUND: The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide patients to surgical resection or watchful waiting is still under debate. Additional markers to better separate low and high-risk lesions would improve patient selection. METHODS: Patients who underwent pancreatic resections for IPMNs between January 2008 and December 2012 with available blood samples were selected and retrospectively assessed. Data on cyst characteristics such as cyst size, duct relation and main-duct dilatation were collected and plasma fibrinogen levels were measured...
April 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28126546/management-of-undifferentiated-solitary-mucinous-cystic-lesion-of-the-pancreas-a%C3%A2-clinical-dilemma
#20
Alexandra M Roch, Katherine Bigelow, Christian M Schmidt, Rosalie A Carr, Andrea L Jester, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
BACKGROUND: Management of solitary mucinous cystic lesions of the pancreas (MCLs) relies on correct differentiation between branch duct intraductal papillary mucinous neoplasm (BD-IPMN) and mucinous cystic neoplasm (MCN). Current international consensus guidelines recommend resection for MCN, and unifocal BD-IPMN can be followed in the absence of worrisome features/high-risk stigmata. We hypothesized that preoperative differentiation of solitary MCLs is suboptimal, and that all solitary MCLs should be treated similarly...
January 24, 2017: Journal of the American College of Surgeons
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