Comparison Between Mucinous Cystic Neoplasm and Intraductal Papillary Mucinous Neoplasm of the Branch Duct Type of the Pancreas With Respect to Expression of CD10 and Cytokeratin 20

Nishigami, Takashi; Onodera, Masayuki; Torii, Ikuko; Sato, Ayuko; Tao, Lihua; Kushima, Ryoji; Kakuno, Ayako; Kishimoto, Mitsuo; Katsuyama, Eiji; Fujimori, Takahiro; Honda, Hiroshi; Satake, Makoto; Kuroda, N.; Nishiguchi, Shuhei; Fujimoto, Jiro; Tsujimura, Tohru

doi:10.1097/mpa.0b013e31819f3bd6

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…This is in line with our results in hepatic mucinous cystic neoplasms. In contrast, MUC5AC and CK20 were expressed in the majority of pancreatic mucinous cystic neoplasms irrespective of the grade of dysplasia, 15,16 which differs markedly from the immunophenotype found in our study.…”

Section: Discussioncontrasting

confidence: 95%

Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct

et al. 2011

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Mucinous cystic neoplasm of the liver has been a controversial entity, in particular, regarding differentiation from intraductal papillary neoplasm of the bile duct. In this study, we compared the characteristics of hepatic mucinous cystic neoplasms with ovarian-like stroma (n ¼ 29) to those of cyst-forming intraductal papillary neoplasms of the bile duct (n ¼ 12). Radiological or macroscopic appearance, histological grade of malignancy, and postoperative clinical course were recorded. Immunohistochemistry for biliary or gastrointestinal markers was performed to characterize cell phenotypes. The patients with hepatic mucinous cystic neoplasm were all female and ranged in age from 21 to 67 years, which was significantly younger than that in the patients with biliary intraductal papillary neoplasm. Eighteen mucinous cystic neoplasms (76%) were located in the left lobe, with 13 (54%) in segment IV. Mucinous cystic neoplasms were significantly larger than intraductal papillary neoplasms (median diameter: 110 vs 50 mm, P ¼ 0.008). In contrast to intraductal papillary neoplasms that were all histologically malignant, 26 mucinous cystic neoplasms (90%) were adenomas, 2 (7%) were borderline malignant, and 1 (3%) was a carcinoma in situ. Benign mucinous cystadenomas had the pure biliary immunophenotype, whereas gastrointestinal markers including cytokeratin 20 and mucin core proteins 2, 5AC, and 6 were more frequently expressed in borderline or malignant mucinous cystic neoplasms and biliary intraductal papillary neoplasms. There was no mortality in the patients with mucinous cystic neoplasm, whereas one patient with intraductal papillary neoplasm died of cancer. In conclusion, hepatic mucinous cystic neoplasms and biliary intraductal papillary neoplasms have different clinicopathological characteristics as evidenced by differences in the age and gender of patients, macroscopic appearance, immunophenotypes, and grades of malignancy.

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Section: Discussioncontrasting

confidence: 95%

Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct

et al. 2011

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“…It seems to be an important molecule in foregut differentiation of cells and has been implicated in gastric and pancreatic carcinogenesis. 8,13,17,22 Furthermore, MUC6 seems to be regulated by key molecules such as Sp and NFkB that have been known to have important roles in pancreatic tumorigenesis. 11,19 …”

mentioning

confidence: 99%

Preferential Expression of MUC6 in Oncocytic and Pancreatobiliary Types of Intraductal Papillary Neoplasms Highlights a Pyloropancreatic Pathway, Distinct From the Intestinal Pathway, in Pancreatic Carcinogenesis

Basturk

Khayyata

Klimstra

et al. 2010

American Journal of Surgical Pathology

114

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The expression of different MUC glycoproteins has helped define cellular lineage in variety of pancreatic neoplasms, and has helped identify distinct carcinogenic pathways such as the intestinal pathway characterized by diffuse/strong MUC2/CDX2 expression in intestinal-type intraductal papillary mucinous neoplasms (IPMNs) and their associated colloid carcinomas (CCs). In this study, the expression profile of MUC6, a pyloric-type mucin, was investigated in both preinvasive and invasive pancreatic neoplasia. Florid papillary (“in-situ”) components of 9 intraductal oncocytic papillary neoplasms (IOPNs), 24 IPMNs, and 7 mucinous cystic neoplasms (MCNs), were analyzed immunohistochemically for MUC6 expression, as were 15 PanINs, 112 usual invasive ductal adenocarcinomas (DAs), and 14 CCs. In PanINs, MUC6 expression was limited to the very early areas of PanIN-1A that typically have pyloric features. Expression was lost in later stages. Similarly, in IOPNs or IPMNs or MCNs, MUC6 expression was detectable in the cystic or flat areas that have pyloric-like histology. However, in the more advanced (papillary) components of these neoplasms, MUC6 expression was mostly limited to the “cuboidal-cell” but was not seen in the “columnar-cell” phenotype: there was diffuse or strong expression in 8/9 IOPN and, relatively weaker but consistent expression in all 6/6 pancreatobiliary-type IPMNs; whereas virtually no expression in villous or intestinal-type IPMNs. The 7/8 gastric or foveolar-type IPMNs were also negative; in the single case with positivity, the labeling was limited to high-grade dysplastic areas. Interestingly, the papillae in MCNs were also mostly negative. Among invasive carcinomas, 39/112 DAs and only 1/14CC expressed MUC6. In DA, the expression did not correlate with survival (P=0.94), or any of the markers of aggressiveness: more than 2-cm tumor size (P=0.76), positive surgical margins (P=0.27), lymph node metastasis (P=0.82), or high grade (P=0.08). In conclusion: (1) The expression of MUC6 in oncocytic and pancreatobiliary-type neoplasms but not in villous or intestinal-type neoplasms supports the presence of a pyloropancreatic pathway distinct from the MUC2/CDX2 expressing intestinal pathway in intraductal papillary neoplasia. (2) MUC6 expression is present in the earliest (nonpapillary) form of any type of preinvasive neoplasia regardless of whether it is PanIN or IOPN or IPMN or MCN suggesting that these entities may share some characteristics early on, but evolve along divergent pathways as they progress.

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“…Overall, most mucinous metaplastic lesions express MUC1 [84], including pancreatic intraepithelial neoplasms (PanIN) and IPMN [85]. Except for the intestinal type, IPMNs in general are negative for CDX2, CD10, and CK20 [86]. Gastric-type IPMNs exhibit expression of MUC5AC, but expression of MUC6 is variable [87].…”

Section: Pathology Of Ipmnmentioning

confidence: 99%

Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update

Xiao

2012

Scientifica

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Intraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas. The etiology is unknown, but increasing evidence suggests the involvement of several tumorigenesis pathways, including an association with hereditary syndromes. IPMN occurs more commonly in men, with the mean age at diagnosis between 64 and 67 years old. At the time of diagnosis, it may be benign, with or without dysplasia, or frankly malignant with an invasive carcinoma. Tumors arising from the main pancreatic duct are termed main-duct IPMNs, those involving the branch ducts, branch-duct IPMNs. In general, small branch-duct IPMNs are benign, particularly in asymptomatic patients, and can be safely followed. In contrast, main-duct tumors should be surgically resected and examined carefully for an invasive component. In the absence of invasion, patient's survival is excellent, from 94 to 100%. For patients with an IPMN-associated invasive carcinoma, the prognosis overall is better than those with a de novo pancreatic ductal adenocarcinoma, with a 5-year survival of 40% to 60% in some series. However, no survival advantage can be demonstrated if the invasive component in an IPMN patient is that of the conventional tubular type (versus mucinous carcinoma). Several histomorphologic variants are recognized, although the clinical significance of this “subtyping” is not well defined.

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Comparison Between Mucinous Cystic Neoplasm and Intraductal Papillary Mucinous Neoplasm of the Branch Duct Type of the Pancreas With Respect to Expression of CD10 and Cytokeratin 20

Cited by 17 publications

References 18 publications

Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct

Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct

Preferential Expression of MUC6 in Oncocytic and Pancreatobiliary Types of Intraductal Papillary Neoplasms Highlights a Pyloropancreatic Pathway, Distinct From the Intestinal Pathway, in Pancreatic Carcinogenesis

Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update

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