High‐grade Pan<scp>IN</scp> presenting with localised stricture of the main pancreatic duct: A clinicopathological and molecular study of 10 cases suggests a clue for the early detection of pancreatic cancer

Yokode, Masayuki; Akita, Masayuki; Fujikura, Kohei; Kim, Mi-Ju; Morinaga, Yukiko; Yoshikawa, Seiichi; Takato, Tsuyoshi; Miyata, Hiroshi; Tajiri, Takuma; Abe‐Suzuki, Shiho; Itoh, Tomoo; Hong, Seung‐Mo; Zen, Yoh

doi:10.1111/his.13629

Cited by 37 publications

(51 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have reported similar findings in other pancreatic precursor lesions, such as PanINs and IPMNs, using next‐generation sequencing or droplet digital PCR. Together, these studies also support the heterogeneity in the tumorigenesis of pancreatic precursor lesions …”

Section: Discussionsupporting

confidence: 66%

See 1 more Smart Citation

Multiple KRAS mutations in the non‐mucinous epithelial lining in the majority of mucinous cystic neoplasms of the pancreas

Kim

et al. 2019

Histopathology

Self Cite

View full text Add to dashboard Cite

Aims Mucinous cystic neoplasms (MCNs) of the pancreas are cystic neoplasms lined by mucinous lining epithelium (MLE) with associated ovarian‐type stroma. Although a non‐MLE (NMLE) can be observed in some MCNs, whether cystic neoplasms with ovarian‐type stroma and NMLE should be classified as MCNs or separately designated is debated. Methods and results To test this, NMLEs were defined as flat or cuboidal epithelial cells without intracytoplasmic mucin. A total of 112 MCNs were reviewed, and the epithelium was classified as NMLE or MLE. A total of 110 females and two males with a mean age of 46.5 ± 12.3 years were included in this study. At least focal NMLE was noted in 76.8% (86/112) of MCNs. The mean percentage of the neoplastic epithelium that was NMLE in these 86 cases was 46%. NMLE was predominant (>50%) in 38.4% (43/112) of cases. MCNs with NMLE were smaller (42 ± 21 mm) than those with MLE (60 ± 36 mm, P < 0.001), and all NMLEs had low‐grade dysplasia. Twelve MCNs with NMLE or MLE were selected for KRAS mutation analysis with droplet digital polymerase chain reaction after laser capture microdissection. All 12 MCNs showed multiple types of KRAS mutation, which were detected in 92% (11/12) of NMLE foci and 89% (8/9) of MLE foci. Predominant NMLE was common in small MCNs with low‐grade dysplasia. Conclusions Clonal KRAS mutations were observed in both NMLE and MLE, supporting the hypothesis that MCNs with NMLE should be classified as MCNs.

show abstract

Section: Discussionsupporting

confidence: 66%

“…The other KRAS gene included the wild‐type gene in all normal cases (G12R, G12C, G12A, and G12V). Allowing a mean + 3 standard deviations, the percentage of each type of KRAS mutation in MCN was normalised on thresholds of 1.1% for G12R, 0.22% for G12D, 0.25% for G13D, and 0% for others, based on previous studies …”

Section: Methodsmentioning

confidence: 99%

Multiple KRAS mutations in the non‐mucinous epithelial lining in the majority of mucinous cystic neoplasms of the pancreas

Kim

et al. 2019

Histopathology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although imaging suggested a solid mass lesion, no discrete nodule was identified histologically. In addition, various conditions such as small cancers, neuroendocrine tumors, or even pancreatic intraepithelial neoplasia that potentially obstruct the duct system were not identified in this case. The single abnormality observed in the adjacent pancreas was pancreatitis with neutrophilic epithelial injury reminiscent of GELs observed in type 2 AIP.…”

Section: Discussionmentioning

confidence: 81%

Duct‐obstructive pancreatitis with granulocytic epithelial lesion in a patient with ulcerative colitis: An atypical manifestation of type 2 autoimmune pancreatitis?

Ahn

Lee

Hwang

et al. 2019

Pathology International

Self Cite

View full text Add to dashboard Cite

Type 2 autoimmune pancreatitis (AIP) typically presents with diffuse or focal enlargement of the pancreas; however, its diverse clinical presentation has not yet been clarified. We herein described a 46‐year‐old man with a 1‐month history of ulcerative colitis who presented with imaging features of a mass‐like lesion in the pancreatic body with upstream duct dilatation and serum CA19‐9 elevation. He underwent laparoscopic distal pancreatectomy with splenectomy for suspected malignancy. Histologically, the area radiologically suspected to be duct dilatation consisted of necrotic tissue, in which the disrupted main pancreatic duct was involved. The area radiologically suspected to be the mass lesion showed features of pancreatitis without discrete mass. In addition, several ducts showed neutrophilic duct injury similar to granulocytic epithelial lesions observed in type 2 AIP. Immunohistochemistry revealed the aberrant expression of IL‐8 in the pancreatic ductules and infiltrating CD3‐positive T‐lymphocytes, findings recently identified in type 2 AIP. The present case is not typical for either type 2 AIP or other known conditions, but extreme examples of type 2 AIP may present with ductal obstruction because of severe neutrophilic duct injury. IL‐8 immunostaining may also assist in establishing a diagnosis of type 2 AIP with an atypical presentation.

show abstract

“…Until now it was thought that PanINs frequently display abnormal p53 expression and loss of SMAD4/DPC4 expression [22,23]. However, recent studies with isolated high-grade PanINs demonstrate that aberrant p53 expression occurs only in 20% of high-grade PanINs and all high-grade PanINs show intact SMAD4/DPC4 expression [24,25]. These discrepancies in previous studies may have been due to the presence of intraductal spread of invasive ductal adenocarcinomas.…”

Section: Paninmentioning

confidence: 99%

“…Intraductal spread, also known as intraductal cancerization, is observed in up to 70% of surgically resected PDACs [27], and is extremely difficult to differentiate from high-grade PanIN on hematoxylin and eosin-stained slides [5]. Loss of SMAD4/DPC4 expression can be a differentiating feature of intraductal spread of invasive PDAC, while high-grade PanIN shows intact SMAD4/DPC4 expression [24,25]. …”

Section: Paninmentioning

confidence: 99%

Precursor Lesions of Pancreatic Cancer

Kim

Hong

2018

Oncol Res Treat

Self Cite

View full text Add to dashboard Cite

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer death. Although the treatment modalities are improving, the prognosis of PDAC continues to be poor. Therefore, early detection of PDAC or its precursor lesions may be the best way to improve patient survival. PDACs have several different precursor lesions, including pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), intraductal tubulopapillary neoplasms (ITPNs), intraductal oncocytic papillary neoplasms (IOPNs), and mucinous cystic neoplasms (MCNs). PanINs cannot be identified using imaging modalities, while the other lesions are radiologically detectable. These precursor lesions are categorized based on structural and cytological atypia as low-grade and high-grade lesions. We discuss recent updates regarding histopathological and molecular pathological overviews of PDAC precursor lesions. Better understanding of such lesions may contribute to earlier detection of PDAC or its precursor lesions and improve PDAC patient survival.

show abstract

High‐grade PanIN presenting with localised stricture of the main pancreatic duct: A clinicopathological and molecular study of 10 cases suggests a clue for the early detection of pancreatic cancer

Cited by 37 publications

References 23 publications

Multiple KRAS mutations in the non‐mucinous epithelial lining in the majority of mucinous cystic neoplasms of the pancreas

Multiple KRAS mutations in the non‐mucinous epithelial lining in the majority of mucinous cystic neoplasms of the pancreas

Duct‐obstructive pancreatitis with granulocytic epithelial lesion in a patient with ulcerative colitis: An atypical manifestation of type 2 autoimmune pancreatitis?

Precursor Lesions of Pancreatic Cancer

Contact Info

Product

Resources

About