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Mucinous cysts of pancreas

Ivan Chebib, Emily Albanese, Aristana Scourtas, Martha B Pitman
BACKGROUND: Inspissated cyst fluid may be identified on pancreatic cyst aspiration cytology. We report on the cytomorphologic characteristics of inspissated cyst fluid on EUS-FNA of pancreatic cysts and correlate this finding with histopathology or multimodal (cytology, cyst fluid analysis, molecular pathology, imaging) classification of cyst type. METHODS: The department archives were searched for pancreatic cyst fine-needle aspiration biopsies that contained dessicated, crystalline or inspissated material on cytologic preparations...
February 24, 2018: Diagnostic Cytopathology
Hideki Mori, Keiji Hanada, Tomoyuki Minami, Shigeki Yano, Motomitsu Fukuhara, Hirotsugu Maruyama, Akinori Shimizu, Naomichi Hirano, Fumiaki Hino, Hironobu Amano, Shuji Yonehara
A previously healthy 52-year-old man was referred to our hospital for further evaluation of main pancreatic duct dilatation. The preoperative work-up was consistent with intraductal papillary mucinous carcinoma (IPMC) derived from a mixed type intraductal papillary mucinous neoplasm (IPMN), because multilocular cysts with enhancing thickened pancreatic head walls and dilated pancreatic ducts lined with dysplastic mucinous epithelium, with papillary proliferation from the pancreatic body to the tail, were observed; in addition, the pancreatic juice cytology was class V, which is suggestive of adenocarcinoma...
February 13, 2018: Clinical Journal of Gastroenterology
Chang Moo Kang, Akira Matsushita, Ho Kyoung Hwang, Yoko Matsuda, Hyunki Kim, Yoshiharu Nakamura, Woo Jung Lee
The present study aimed to elucidate the clinicopathological characteristics of resected mucinous cystic neoplasm (MCN) with ovarian-type stroma and identify a surgical approach for MCN treatment, on the basis of Republic of Korean (Yonsei University College of Medicine, Seoul, South Korea) and Japanese (Nippon Medical School, Tokyo, Japan) bi-institutional collaboration. The present study retrospectively reviewed 55 MCNs with ovarian-type stroma using pathological re-examination. Clinicopathological features and preoperative clinical parameters were evaluated to predict malignant alterations in MCNs...
February 2018: Oncology Letters
Kazuhide Shimamatsu, Yoshiki Naito, Yutaro Mihara, Masamichi Nakayama, Masahiko Tanigawa, Yushi Abe, Ken Nakamura, Toshihiro Araki, Kenji Sakata, Kazunori Noguchi, Jun Akiba, Hirohisa Yano, Osamu Nakashima
The present case study documents an autopsy case of granulocyte-colony stimulating factor (G-CSF)-producing mucinous cystic neoplasm (MCN), with an associated invasive carcinoma of the pancreas. A 65-year-old woman presented to Omuta City Hospital (Omuta Japan) with a primary complaint of abdominal pain. Multiple liver nodules and a pancreatic cyst were detected upon abdominal computed tomography. Initially, liver abscess was suspected as the patient exhibited leukocytosis and elevated C-reactive protein level...
February 2018: Oncology Letters
Maxime Hamon, Pierre Balladur, Jean-François Fléjou
Simple mucinous cyst of the pancreas is an unusual pancreatic cyst, first described by Kosmahl et al. in 2002 with 5 cases. We describe a case of simple mucinous cyst of the pancreas, followed by a literature review. The physiopathology of this cyst is still unclear. It is an epithelial cyst, presenting as unilocular cystic lesion of the pancreatic body or tail, with a clear content, and no communication with the pancreatic duct. Microscopically, the cyst is lined by mucin-producing cells with mild atypia, and contains a fibrous wall without ovarian-like stroma...
February 4, 2018: Annales de Pathologie
Tiana J Raphel, Davis T Weaver, Lincoln L Berland, Brian R Herts, Alec J Megibow, Amy B Knudsen, Pari V Pandharipande
Purpose To determine the effects of patient age and comorbidity level on life expectancy (LE) benefits associated with imaging follow-up of Bosniak IIF renal cysts and pancreatic side-branch (SB) intraductal papillary mucinous neoplasms (IPMNs). Materials and Methods A decision-analytic Markov model to evaluate LE benefits was developed. Hypothetical cohorts with varied age (60-80 years) and comorbidities (none, mild, moderate, or severe) were evaluated. For each finding, LE projections from two strategies were compared: imaging follow-up and no imaging follow-up...
February 5, 2018: Radiology
Corina Lupascu-Ursulescu, Ana-Maria Trofin, Mihai Zabara, Alexandra Vornicu, Ramona Cadar, Oana Apopei, Gabriela Stefanescu, Cristian Lupascu
INTRODUCTION: Bleeding from isolated gastric varices, though uncommon, may be life threatening and may occur as a consequence of splenic vein thrombosis by tumoral compression and subsequent left-sided portal hypertension. CASE OVERVIEW: We report the case of a 37-year old woman, previously diagnosed with a benign pancreatic cyst, who presented with severe gastric variceal bleeding. DIAGNOSIS, THERAPEUTICS INTERVENTIONS, AND OUTCOMES: Abdominal ultrasound (US) and computed-tomography (CT) revealed enlargement and changed morphology of the cystic tumor located on the body of the pancreas...
November 2017: Medicine (Baltimore)
Koji Takahashi, Rintaro Mikata, Toshio Tsuyuguchi, Junichiro Kumagai, Masato Nakamura, Yotaro Iino, Ayako Shingyoji, Mutsumi Yamato, Hiroshi Ohyama, Yuko Kusakabe, Shin Yasui, Harutoshi Sugiyama, Takashi Kishimoto, Yukio Nakatani, Naoya Kato
A 68-year-old woman was referred to our hospital for the treatment of bile duct stone, pancreatic tumor, and pancreatic cysts. First, bile duct stone was removed using endoscopic retrograde cholangiopancreatography. By abdominal contrast-enhanced computed tomography, a 12-mm diameter tumor was found in the pancreatic body. The tumor was isodense compared with the surrounding pancreatic parenchyma in the non-contrast phase and poorly enhanced in the arterial phase; it exhibited gradual enhancement from the portal vein phase to the late phase...
January 27, 2018: Clinical Journal of Gastroenterology
Ken Liu, Vikram Joshi, Louise van Camp, Qi-Wei Yang, Judith E Baars, Simone I Strasser, Geoffrey W McCaughan, Avik Majumdar, Payal Saxena, Arthur J Kaffes
AIM: To determine the prevalence, characteristics and clinical course of pancreatic cystic neoplasms (PCNs) in liver transplantation (LT) recipients. METHODS: We retrospectively studied consecutive patients who underwent LT between January 1998 to April 2016. Clinical and laboratory data were obtained from patient medical records. Imaging findings on computed tomography and magnetic resonance cholangiopancreatography were reviewed by two radiologists. RESULTS: During the study period, 872 patients underwent cadaveric LT...
December 28, 2017: World Journal of Gastroenterology: WJG
Vicente Morales-Oyarvide, Zhi Ven Fong, Carlos Fernández-Del Castillo, Andrew L Warshaw
Intraductal papillary mucinous neoplasms (IPMN) are cystic neoplasms with the potential for progression to pancreatic cancer. Recognized by the global medical community just over two decades ago, IPMN have gained great epidemiological and clinical relevance thanks to the widespread use of cross-sectional abdominal imaging, which has led to a surge in the number of incidental pancreatic cysts being diagnosed. As our understanding of this disease has improved, we now know that some IPMN have a very elevated risk of cancer and require surgical resection, while others are low-risk lesions and can be followed...
December 2017: Visceral Medicine
Laura Uribarri-Gonzalez, Margaret G Keane, Stephen P Pereira, Julio Iglesias-García, J Enrique Dominguez-Muñoz, Jose Lariño-Noia
BACKGROUND/OBJECTIVES: To evaluate the agreement between the imaging modalities MRI-MRCP and EUS in cystic lesions of the pancreas which were thought to be a BD-IPMN. METHODS: Multicenter retrospective study included all patients between 2010 and 2015 with a suspected BD-IPMN who underwent an EUS and MRI-MRCP within 6 months or less of each other. Location, number, size, worrisome features and high-risk stigmata were evaluated. Interobserver agreement was evaluated by Kappa score...
January 4, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Belén Martínez, Juan F Martínez, José R Aparicio
Background: This study aimed to determine the prevalence of incidental pancreatic cysts in patients undergoing upper endoscopic ultrasound without a known pancreatic abnormality. Methods: This prospective study was conducted in two hospitals in Spain and enrolled consecutive patients referred for upper endoscopic ultrasound for a condition unrelated to the pancreas. Patients with a previous pancreatic anomaly, history of acute or chronic pancreatitis, evidence of acute pancreatitis, previous upper gastrointestinal surgery, or chronic abdominal pain suggestive of pancreatic origin were excluded...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Seo Yeon Youn, Sung Eun Rha, Eun Sun Jung, In Seok Lee
Most pancreatic ductal adenocarcinomas (PDAs) show solid growth pattern, but ductal adenocarcinomas may demonstrate intratumoral cystic appearance or accompany peritumoral non-neoplastic cystic lesions, thus mimicking cystic pancreatic tumors on imaging studies. The histopathologic findings for PDA with cystic feature are divided into neoplastic and non-neoplastic cysts. Neoplastic cystic changes include large-duct type cysts (microcystic appearance), neoplastic mucin cysts (macrocystic appearance), colloid carcinomas (mucinous noncystic adenocarcinomas), and degenerative cystic change usually caused by hemorrhagic necrosis of tumor...
January 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Akira Umemura, Kazuyuki Ishida, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Kenji Makabe, Akira Sasaki
An intraductal tubulopapillary neoplasm (ITPN) is a very rare pancreatic tumor. Here we report an extremely rare case of an ITPN rupturing and causing acute peritonitis. A 50-year-old woman presented with left flank pain and vomiting. A computed tomography (CT) scan revealed gigantic multilocular cysts in the pancreatic tail and massive fluid collection in the abdominal cavity. The serum, urine, and abdominal fluid amylase levels were highly elevated, so she was conservatively treated with intraperitoneal drainage and antibiotics for a diagnosis of ruptured pancreatic cysts...
September 2017: Case Reports in Gastroenterology
I L Eok Jo, Dae Hwan Kang, Cheol Woong Choi, Hyung Wook Kim, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Hemosuccus pancreaticus is an unusual gastrointestinal hemorrhage through the main pancreatic duct. We report a rare case of hemosuccus pancreaticus due to a simple mucinous cyst of the pancreas. A 52-year-old man who had been followed-up for a suspected branch duct intraductal papillary mucinous neoplasm (IPMN) visited the emergency room due to hematochezia. Endoscopy showed active bleeding from the ampulla. Computed tomography revealed hemorrhage in a 2.0-cm cystic mass in the pancreatic body. The patient was diagnosed with hemosuccus pancreaticus caused by bleeding into the main pancreatic duct from suspected IPMN...
December 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Tatsuo Hata, Marco Dal Molin, Anne McGregor-Das, Tae Jun Song, Christopher Wolfgang, James R Eshleman, Ralph H Hruban, Michael Goggins
Telomere end-to-end fusions are an important source of chromosomal instability that arise in cells with critically shortened telomeres. We developed a nested real-time quantitative PCR method for telomere fusion detection in pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms (IPMNs), and IPMN cyst fluids. Ninety-one pancreatic cancer cell lines and xenograft samples, 93 IPMNs, and 93 surgically aspirated IPMN cyst fluid samples were analyzed. The association between telomere shortening, telomerase activity, and telomere fusion detection was evaluated...
January 2018: Journal of Molecular Diagnostics: JMD
Kiara A Tulla, Ajay V Maker
PURPOSE: Predicting the biologic behavior of intraductal papillary mucinous neoplasm (IPMN) remains challenging. Current guidelines utilize patient symptoms and imaging characteristics to determine appropriate surgical candidates. However, the majority of resected cysts remain low-risk lesions, many of which may be feasible to have under surveillance. We herein characterize the most promising and up-to-date molecular diagnostics in order to identify optimal components of a molecular signature to distinguish levels of IPMN dysplasia...
December 7, 2017: Langenbeck's Archives of Surgery
Ken Ichikawa, Kana Hattori, Tomoki Kusafuka, Takao Omori, Yasuo Ohkura, Takashi Hamada, Hiroki Taoka, Hiroki Tanaka, Shimpei Matsusaki, Youichirou Baba
A 65-year-old male was referred to our hospital 2 years ago for a multilocular cyst accompanied with a protein plug in the pancreas tail. He was diagnosed as having branch duct-type intraductal papillary mucinous neoplasm and was followed-up. Two years later, endoscopic ultrasonography revealed a hypoechoic lesion, 10mm in diameter, near the cyst-like lesion. Finally, he was diagnosed with small pancreatic adenocarcinoma concomitant with intraductal papillary mucinous neoplasm and underwent radical distal pancreatectomy with splenectomy...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Vicente Morales-Oyarvide, Mari Mino-Kenudson, Cristina R Ferrone, Andrew L Warshaw, Keith D Lillemoe, Dushyant V Sahani, Ilaria Pergolini, Marc A Attiyeh, Mohammad Al Efishat, Neda Rezaee, Ralph H Hruban, Jin He, Matthew J Weiss, Peter J Allen, Christopher L Wolfgang, Carlos Fernández-Del Castillo
AIM: The aim of this paper is to describe the characteristics of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas in young patients. METHODS: We evaluated 1693 patients from the Pancreatic Surgery Consortium who underwent resection for IPMN and classified them as younger or older than 50 years of age at the time of surgery. We assessed the relationship of age with clinical, radiological, pathological, and prognostic features. RESULTS: We identified 90 (5%) young patients...
February 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Talal M Al-Qaoud, Eric J Martinez, Hans W Sollinger, Dixon B Kaufman, Robert R Redfield, Bridget Welch, Glen Leverson, Jon S Odorico
Literature on the behavior of cystic lesions in pancreas transplants is scarce, and hence a better understanding is warranted. Data on recipients and their respective donors that underwent simultaneous kidney and pancreas, pancreas transplant alone, and pancreas after kidney between 1994-2015 were reviewed (n=1185). Cystic lesions of the transplant pancreas developed in 22 patients (1.8%): 12 pseudocysts, 2 cysts/remnants, 4 intraductal papillary mucinous neoplasms (IPMN), 2 adenocarcinomas, 1 low grade intraepithelial pancreatic neoplasia, and 1 case of polycystic kidney disease...
October 11, 2017: American Journal of Transplantation
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