Intestinal and oncocytic variants of pancreatic intraepithelial neoplasia. A morphological and immunohistochemical study

Albores‐Saavedra, Jorge; Wu, Jianhua; Crook, Terri W.; Amirkhan, Robin H.; Jones, Lamar; Hruban, Ralph H.

doi:10.1016/j.anndiagpath.2004.12.002

Cited by 20 publications

(14 citation statements)

References 24 publications

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“…Although the expression of CK20 was typically negative in both BilIN and PanIN in this study (data not shown), BilIN is not infrequently associated with metaplastic change of intestinal type, while intestinal-type PanIN is generally not found [12, 13]. These observations may explain the focal MUC2 expression in BilIN rather than in PanIN.…”

Section: Resultsmentioning

confidence: 50%

Histological Characterization of Biliary Intraepithelial Neoplasia with respect to Pancreatic Intraepithelial Neoplasia

Sato

Harada

Sasaki

et al. 2014

International Journal of Hepatology

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Biliary intraepithelial neoplasia (BilIN) is a precursor lesion of hilar/perihilar and extrahepatic cholangiocarcinoma. BilIN represents the process of multistep cholangiocarcinogenesis and is the biliary counterpart of pancreatic intraepithelial neoplasia (PanIN). This study was performed to clarify the histological characteristics of BilIN in relation to PanIN. Using paraffin-embedded tissue sections of surgically resected specimens of cholangiocarcinoma associated with BilIN and pancreatic ductal adenocarcinoma associated with PanIN, immunohistochemical staining was performed using primary antibodies against MUC1, MUC2, MUC5AC, cyclin D1, p21, p53, and S100P. For mucin staining, Alcian blue pH 2.5 was used. Most of the molecules examined here showed similar expression patterns in BilIN and PanIN, in which their expression tended to increase along with the increase in atypia of the epithelial lesions. Significant differences were observed in the increase in mucin production and the expression of S100P in PanIN-1 and the expression of p53 in PanIN-3, when compared with those in BilIN of a corresponding grade. These results suggest that cholangiocarcinoma and pancreatic ductal adenocarcinoma share, at least in part, a common carcinogenic process and further confirm that BilIN can be regarded as the biliary counterpart of PanIN.

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Section: Resultsmentioning

confidence: 50%

Histological Characterization of Biliary Intraepithelial Neoplasia with respect to Pancreatic Intraepithelial Neoplasia

Sato

Harada

Sasaki

et al. 2014

International Journal of Hepatology

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“…2 and Supplementary Figures 8–12) is observed in 50% of IOPN‐P and IOPN‐B cases, and this proportion is comparable to IPMN‐P and IPMN‐B. The invasive carcinomas derived from IOPN‐P and IOPN‐B in the majority of cases have a tubular appearance (small glands or cribriform structures in desmoplastic stroma), but invasive solid nests without prominent desmoplasia may also be noticed [17, 18, 51]. Invasive compartments may retain or lose oncocytic features.…”

Section: Resultsmentioning

confidence: 99%

“…Ki‐67 proliferative index in IOPN‐P ranges from 5 to 30% [17, 51] and from 10% to 25% in IOPN‐B [18, 40, 42]. Proliferative activity of invasive carcinomas derived from IOPN was not specifically described.…”

Section: Resultsmentioning

confidence: 99%

Intraductal oncocytic papillary neoplasms of the pancreas and bile ducts: a description of five new cases and review based on a systematic survey of the literature

Liszka

Pająk

Zielińska-Pająk

et al. 2010

J Hepato Biliary Pancreat

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Background Intraductal oncocytic papillary neoplasms (IOPN) are rare tumors of the pancreatic and biliary ductal system. It is not absolutely clear if the molecular and clinicopathologic characteristics of IOPN differ significantly from other related lesions, namely intraductal papillary mucinous neoplasms (IPMN). Therefore it is not clear if it is reasonable to consider IOPN as a separate diagnostic and clinical entity. Methods In order to describe the clinicopathologic characteristics of IOPN and to compare them with the IPMN profile, we performed a systematic review of the literature and additionally studied five previously unreported IOPN cases. Results IOPN differ from IPMN by lack of K-ras gene mutations in all studied cases. Several differences in the clinical and biological profile between IOPN and IPMN exist, but they are of quantitative rather than of qualitative nature. Additionally, pancreaticobiliary or gastric-foveolar IPMN components may coexist with IOPN component within a single lesion, which suggests at least a partial relation of the pathogenetic pathways of IPMN and IOPN. Importantly, the pathogenesis of accumulation of mitochondria and oxyphilic appearance of IOPN remains unknown. Conclusions At present, there are no reliable criteria other than histopathological picture and K-ras gene status to differentiate IOPN from IPMN. In particular, no clear differences in optimal treatment options and prognosis between these tumors are known. Further studies are needed to clarify the biology of IOPN and to establish their position in clinicopathologic classifications of pancreatic tumors.

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“…In most instances, tumours with oncocytic features are well-defined entities, such as mucinous exocrine pancreatic tumours [3], pancreatic intraepithelial neoplasia [1], intraductal papillary neoplasms [20,31], thus, not representing difficulties in their differential diagnosis. However, oncocytic carcinomas, lacking neuroendocrine markers of differentiation or neurosecretory granules by electron microscopy, with predominant solid growth patterns and tumour cells with abundant eosinophilic cytoplasm have been observed and may represent a diagnostic problem [4,19,32,38,42].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, cases of oncocytic tumours of the pancreas lacking neuroendocrine marker expression have been described [4,19,32,38,42]. Moreover, oncocytic changes have been described in mucinous exocrine pancreatic tumours [3], in pancreatic intraepithelial neoplasia [1] and in intraductal papillary neoplasms [20,31]. In addition, when diagnosed as metastatic deposits in the liver, differential diagnosis with primary hepatocellular carcinoma or with metastases from oncocytic tumours from other sites should also be considered.…”

Section: Introductionmentioning

confidence: 97%

Clinico-pathological features of a series of 11 oncocytic endocrine tumours of the pancreas

et al. 2006

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Oncocytic changes may occur very infrequently in neuroendocrine tumours. To estimate the prevalence, pathological features and clinical behaviour of oncocytic endocrine tumours of the pancreas, we reviewed a series of 227 lesions from two institutions. Eleven cases with predominant oncocytic features were selected, representing 4.85% of the whole series. The morphological features and immunophenotype of such tumours did not differ from conventional endocrine pancreatic tumours, except for the presence of abundant eosinophilic and granular cytoplasm. Anti-mitochondrial antigen was positive in all cases tested, and by electron microscopy, numerous mitochondria were observed in the cytoplasm of tumour cells. The majority of cases were nonfunctioning, and in most cases, pathologic signs of malignancy, leading to a diagnosis of endocrine carcinoma, were observed. In addition, the three nonmalignant cases matched the criteria of well-differentiated tumours of uncertain malignant potential. Nearly 50% of the cases were clinically aggressive, and lymph node and liver metastases were present at the time of diagnosis in a minority of cases. Therefore, oncocytic endocrine pancreatic tumours represent a peculiar morphological and clinical variant characterised by frequent hormonal inactivity and malignant behaviour, which should be considered in the differential diagnosis, especially when dealing with a metastatic lesion.

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Intestinal and oncocytic variants of pancreatic intraepithelial neoplasia. A morphological and immunohistochemical study

Cited by 20 publications

References 24 publications

Histological Characterization of Biliary Intraepithelial Neoplasia with respect to Pancreatic Intraepithelial Neoplasia

Histological Characterization of Biliary Intraepithelial Neoplasia with respect to Pancreatic Intraepithelial Neoplasia

Intraductal oncocytic papillary neoplasms of the pancreas and bile ducts: a description of five new cases and review based on a systematic survey of the literature

Clinico-pathological features of a series of 11 oncocytic endocrine tumours of the pancreas

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