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Mucinous cysts of pancreas

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https://www.readbyqxmd.com/read/27926784/preoperative-characteristics-and-cytological-features-of-136-histologically-confirmed-pancreatic-mucinous-cystic-neoplasms
#1
Aristana Scourtas, Jonathan C Dudley, William R Brugge, Abdurrahman Kadayifci, Mari Mino-Kenudson, Martha B Pitman
BACKGROUND: Mucinous cystic neoplasms (MCNs) of the pancreas present a management conundrum. The majority are benign but all are resected due to their malignant potential. Recent studies have recommended nonsurgical management. In the current study, the authors analyzed the preoperative imaging, cytology, and cyst fluid characteristics of 136 histologically confirmed MCNs to assess predictors of a high-risk (HR) cyst for surgical triage. METHODS: MCNs resected at the Massachusetts General Hospital between 1990 and 2014 formed the study cohort...
December 7, 2016: Cancer
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
#2
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/27889754/serous-cystadenoma-of-the-pancreas-potentials-and-pitfalls-of-a-preoperative-cytopathologic-diagnosis
#3
Mohammed T Lilo, Christopher J VandenBussche, Derek B Allison, Anne Marie Lennon, Bouchra K Younes, Ralph H Hruban, Christopher L Wolfgang, Syed Z Ali
OBJECTIVES: Pancreatic serous cystadenomas (SCAs) are benign tumors. Technological advances in imaging have led to increased recognition of asymptomatic pancreatic cysts, consequently increasing the demand for cytomorphologic evaluations of cyst fluid. STUDY DESIGN: A retrospective search through the pathology archives over an 11-year period was performed to identify SCAs from pancreatectomy specimens with a presurgical pancreatic EUS-guided fine-needle aspiration (FNA)...
November 26, 2016: Acta Cytologica
https://www.readbyqxmd.com/read/27824244/a-large-multicenter-study-of-recurrence-after-surgical-resection-of-branch-duct-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#4
Linda Yan, Ali A Siddiqui, Sobia Laique, Monica Saumoy, Michel Kahaleh, Joseph Yoo, Ankush Kalra, Arun Mathew, Jessica Sterling, Rema Rao, Michael Lieberman, Natalie Cosgrove
BACKGROUND: Surgery for pancreatic branch-duct intraductal papillary mucinous neoplasm (BDIPMN) is indicated for therapy of symptomatic patients and to prevent development of invasive cancer. There is currently no consensus on management of BD-IPMN patients after surgical resection. The aim of this retrospective multicenter study was to determine the recurrence and long-term survival after surgical resection of BD-IPMN and to determine the predictive factors of recurrence. METHODS: All patients who underwent surgery for BD-IPMN from 2005 to 2011 at 2 centers were identified...
November 8, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27760255/association-of-preoperative-risk-factors-with-malignancy-in-pancreatic-mucinous-cystic-neoplasms-a-multicenter-study
#5
Lauren M Postlewait, Cecilia G Ethun, Mia R McInnis, Nipun Merchant, Alexander Parikh, Kamran Idrees, Chelsea A Isom, William Hawkins, Ryan C Fields, Matthew Strand, Sharon M Weber, Clifford S Cho, Ahmed Salem, Robert C G Martin, Charles Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed Ahmad, Daniel E Abbott, Gregory C Wilson, David A Kooby, Shishir K Maithel
Importance: Pancreatic mucinous cystic neoplasms (MCNs) harbor malignant potential, and current guidelines recommend resection. However, data are limited on preoperative risk factors for malignancy (adenocarcinoma or high-grade dysplasia) occurring in the setting of an MCN. Objectives: To examine the preoperative risk factors for malignancy in resected MCNs and to assess outcomes of MCN-associated adenocarcinoma. Design, Setting, and Participants: Patients who underwent pancreatic resection of MCNs at the 8 academic centers of the Central Pancreas Consortium from January 1, 2000, through December 31, 2014, were retrospectively identified...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27740966/-simple-mucinous-cyst-of-the-pancreas-a-clinicopathologic-analysis-of-39-examples-of-a-diagnostically-challenging-entity-distinct-from-intraductal-papillary-mucinous-neoplasms-and-mucinous-cystic-neoplasms
#6
Alyssa M Krasinskas, Gerard J Oakley, Pelin Bagci, Kee-Taek Jang, Shih-Fan Kuan, Michelle D Reid, Ipek Erbarut, Volkan Adsay
Pancreatic cysts >1 cm lined by nonpapillary mucinous epithelium without ovarian-type stroma pose diagnostic challenges. The term "simple mucinous cyst" was recently proposed for this entity. Our goal was to determine the clinicopathologic characteristics of these cysts, as they have not been previously described. Of the 39 patients with pancreatic resections included in this study, the mean age was 65 years and the female-to-male ratio was 4:1. The characteristics of the cysts are as follows: 82% had elevated cyst fluid carcinoembryonic antigen levels, 67% were unilocular, 69% occurred in the body/tail, 92% did not communicate with pancreatic ducts, the mean size was 2...
October 12, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27693645/comparing-3-guidelines-on-the-management-of-surgically-removed-pancreatic-cysts-with-regard-to-pathological-outcome
#7
Selma J Lekkerkerker, Marc G Besselink, Olivier R Busch, Joanne Verheij, Marc R Engelbrecht, Erik A Rauws, Paul Fockens, Jeanin E van Hooft
BACKGROUND AND AIMS: Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathological outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. METHODS: Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present)...
September 29, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27673548/nonmucinous-biliary-epithelium-is-a-frequent-finding-and-is-often-the-predominant-epithelial-type-in-mucinous-cystic-neoplasms-of-the-pancreas-and-liver
#8
Kristen Zhelnin, Yue Xue, Brian Quigley, Michelle D Reid, Hyejeong Choi, Bahar Memis, Volkan Adsay, Alyssa M Krasinskas
Mucinous cystic neoplasms (MCNs) can occur in the pancreas and liver. Classically, these cystic lesions are lined by columnar mucinous epithelium with underlying ovarian-type stroma. It has been proposed that cysts with ovarian-type stroma and nonmucinous epithelium be considered separate entities in both the pancreas and liver. Using a series of 104 pancreatic and 32 hepatic cases, we aimed to further characterize the epithelium present in MCNs. Mucinous epithelium was defined as pancreatic intraepithelial neoplasia-like columnar cells with pale pink/clear apical mucin...
September 26, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27631774/neutrophil-to-lymphocyte-ratio-is-a-predictive-marker-for-invasive-malignancy-in-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#9
Georgios Gemenetzis, Fabio Bagante, James F Griffin, Neda Rezaee, Ammar A Javed, Lindsey L Manos, Anne M Lennon, Laura D Wood, Ralph H Hruban, Lei Zheng, Atif Zaheer, Elliot K Fishman, Nita Ahuja, John L Cameron, Matthew J Weiss, Jin He, Christopher L Wolfgang
OBJECTIVE: To evaluate the correlation between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) values, and the presence of invasive carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). BACKGROUND: NLR and (PLR) are inflammatory markers that have been associated with overall survival in patients with invasive malignancies, including pancreatic cancer. METHODS: We retrospectively reviewed 272 patients who underwent surgical resection for histologically confirmed IPMN from January 1997 to July 2015...
September 14, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27607098/proposed-nomogram-predicting-the-individual-risk-of-malignancy-in-the-patients-with-branch-duct-type-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#10
Jin-Young Jang, Taesung Park, Selyeong Lee, Yongkang Kim, Seung Yeoun Lee, Sun-Whe Kim, Song-Cheol Kim, Ki-Byung Song, Masakazu Yamamoto, Takashi Hatori, Seiko Hirono, Sohei Satoi, Tsutomu Fujii, Satoshi Hirano, Yasushi Hashimoto, Yashuhiro Shimizu, Dong Wook Choi, Seong Ho Choi, Jin Seok Heo, Fuyuhiko Motoi, Ippei Matsumoto, Woo Jung Lee, Chang Moo Kang, Ho-Seong Han, Yoo-Seok Yoon, Masayuki Sho, Hiroaki Nagano, Goro Honda, Sang Geol Kim, Hee Chul Yu, Jun Chul Chung, Yuichi Nagakawa, Hyung Il Seo, Hiroki Yamaue
OBJECTIVES: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. BACKGROUND: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. METHODS: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan...
September 6, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27588410/quantitative-imaging-to-evaluate-malignant-potential-of-ipmns
#11
Alexander N Hanania, Leonidas E Bantis, Ziding Feng, Huamin Wang, Eric P Tamm, Matthew H Katz, Anirban Maitra, Eugene J Koay
OBJECTIVE: To investigate using quantitative imaging to assess the malignant potential of intraductal papillary mucinous neoplasms (IPMNs) in the pancreas. BACKGROUND: Pancreatic cysts are identified in over 2% of the population and a subset of these, including intraductal papillary mucinous neoplasms (IPMNs), represent pre-malignant lesions. Unfortunately, clinicians cannot accurately predict which of these lesions are likely to progress to pancreatic ductal adenocarcinoma (PDAC)...
August 31, 2016: Oncotarget
https://www.readbyqxmd.com/read/27550882/obstructive-jaundice-as-a-complication-of-macrocystic-serous-cystadenoma-of-the-pancreas
#12
Hendra Koncoro, I Komang W D Putra, I Dewa N Wibawa
Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion...
April 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/27536368/accuracy-of-2012-international-consensus-guidelines-for-the-prediction-of-malignancy-of-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#13
Enrique Pérez-Cuadrado Robles, Frédérique Maire, Jérôme Cros, Marie-Pierre Vullierme, Vinciane Rebours, Alain Sauvanet, Alain Aubert, Safi Dokmak, Philippe Lévy, Philippe Ruszniewski
OBJECTIVE: To determine accuracy of 2012 International Consensus Guidelines (ICG) predicting malignancy in a surgical cohort of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN). METHODS: This study included all consecutive patients with final pathological diagnosis of pure BD-IPMN resected between 2006 and 2014 at Beaujon Hospital. Neoplasms were classified as malignant in presence of high-grade dysplasia (HGD) or invasive carcinoma. Medical, pathological, and radiological data were retrospectively recorded...
August 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/27502606/treatment-of-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-state-of-the-art
#14
REVIEW
Stefano Crippa, Alessandra Piccioli, Maria Chiara Salandini, Chiara Cova, Francesca Aleotti, Massimo Falconi
The diagnosis of branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) has been dramatically increased. BD-IPMNs are frequently discovered as incidental findings in asymptomatic individuals, mainly in elderly patients. An accurate evaluation of BD-IPMNs with high-resolution imaging techniques and endoscopic ultrasound is necessary. Patients with high-risk stigmata (HRS, obstructive jaundice, enhanced solid component) should undergo resection. Patients with worrisome features (WF, cyst size ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, and clinical acute pancreatitis) may undergo either a strict surveillance based on patients' characteristics (age, comorbidities) or surgical resection...
September 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27467864/mri-findings-of-intraductal-papillary-mucinous-neoplasms-ipmns
#15
Silvia Lana, Manuela Vallara, Nicola Emanuele Bono, Giuseppe Russo, Giulia Artioli, Giovanni Capretti, Ilaria Paladini, Antonella Pesce, Margherita Ruggirello, Sandro Barbalace, Maurizio Mostardi
Cystic lesions of the pancreas are relatively frequent imaging findings due to the improvement of imaging technologies. They may be secondary to both benign and malignant disease processes and their prevalence increases with age. In most cases, these lesions are detected incidentally by computed tomography and magnetic resonance imaging (MRI) performed for other reasons. Intraductal papillary mucinous neoplasms (IPMNs) represent 25% of the cystic neoplasms, morphologically classified into "main pancreatic duct IPMN" (MPD-IPMN), "side branches IPMN" (SB-IPMN) and mixed forms...
2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27459913/pancreatic-juice-cytology-as-sensitive-test-for-detecting-pancreatic-malignancy-in-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-without-mural-nodule
#16
Natsuko Kawada, Hiroyuki Uehara, Shigenori Nagata, Yasuhiko Tomita, Hideji Nakamura
OBJECTIVE: Recent studies reported that mural nodule (MN) was the most associated with malignant intraductal papillary mucinous neoplasms (IPMNs). However, IPMNs without MN cannot be diagnosed as malignant if only MN is determined to be indicator of malignancy. This study aimed to investigate role of pancreatic juice cytology for IPMNs without MN. METHODS: Medical records of 50 patients with histologically proven malignant IPMNs were reviewed. Exclusively for non-invasive cancer, extent of high-grade dysplasia along the main pancreatic duct (MPD) was determined microscopically...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27403123/lymphoepithelial-cyst-of-the-pancreas
#17
Prabhu Arumugam, Natalie Fletcher, Charis Kyriakides, Lisa Mears, Hemant M Kocher
Lymphoepithelial cyst (LEC) of the pancreas is an extremely rare, benign pancreatic cystic lesion that is difficult to differentiate preoperatively from other cystic pancreatic lesions. LEC may have malignant potential. Here, we describe a case of LEC of the pancreas - initially suspected to be a mucinous cyst neoplasm - in an elderly man presenting with abdominal pain, who went on to have a distal pancreatectomy and splenectomy. We also review the relevant literature and discuss implications for the diagnosis and management of this rare lesion...
January 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27246174/molecular-analysis-of-mucinous-nonneoplastic-cyst-of-the-pancreas
#18
Bing Zhu, Sydney D Finkelstein, Gong Feng, Rajesh N Keswani, Xiaoqi Lin
Although a mucinous nonneoplastic cyst (MNNC) of the pancreas is defined as a benign nonneoplastic lesion with no malignant potential, its histogenesis and etiology are still uncertain. To explore the origin and development of MNNC, we searched for neoplasia-associated mutational change in oncogene and tumor suppressor genes. Specifically, we analyzed KRAS oncogene mutations by polymerase chain reaction/dideoxy DNA (Sanger) sequencing and tumor suppression gene deletion by loss of heterozygosity (LOH) using polymerase chain reaction/capillary gel electrophoresis for a panel of 16 polymorphic microsatellite repeat markers targeting common tumor suppression gene loci at 1p, 3p, 5q, 9p, 10q, 17p, 17q, 18q, 21q, and 22q on DNA isolated from the cystic lining epithelium microdissected from 15 surgically diagnosed MNNCs by microdissection of unstained histologic sections of fixed resection specimens...
September 2016: Human Pathology
https://www.readbyqxmd.com/read/27230996/routine-cyst-fluid-cytology-is-not-indicated-in-the-evaluation-of-pancreatic-cystic-lesions
#19
Lawrence A Shirley, Jon Walker, Somashekar Krishna, Samer El-Dika, Peter Muscarella, E Christopher Ellison, Carl R Schmidt, Mark Bloomston
BACKGROUND: The work-up of cystic lesions of the pancreas often involves endoscopic ultrasound (EUS) with fine needle aspiration (FNA). In addition to CEA and amylase measurement, fluid is routinely sent for cytologic examination. We evaluated the utility of cytologic findings in clinical decision-making. MATERIALS AND METHODS: Records of patients who underwent EUS-guided pancreatic cyst aspiration were reviewed. Findings from axial imaging and EUS were compared to cyst fluid cytology as well as fluid amylase and CEA...
September 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27171512/development-and-potential-utility-of-a-new-scoring-formula-for-prediction-of-malignant-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#20
Yutaka Suzuki, Tetsuya Nakazato, Masaaki Yokoyama, Masaharu Kogure, Ryota Matsuki, Nobutsugu Abe, Toshiyuki Mori, Yasuo Ohkura, Masanori Sugiyama
OBJECTIVE: A simple system is needed to determine whether surgery is indicated in cases of intraductal papillary mucinous neoplasm (IPMN). METHODS: We conducted a retrospective study to identify factors predictive of malignant IPMN and thus simplify the treatment decision-making process. Ninety-six consecutive patients treated surgically for IPMN at Kyorin University Hospital (Tokyo, Japan) between 1994 and 2014 were included. Univariate and multivariate analyses were used to identify preoperative factors predictive of malignancy...
October 2016: Pancreas
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