Pseudointraductal papillary mucinous neoplasia caused by microscopic periductal endocrine tumors of the pancreas: a report of 3 cases

Kenney, Barton; Singh, Gayatri; Salem, Ronald R.; Paterno, Flavio; Robert, Marie E.; Jain, Dhanpat

doi:10.1016/j.humpath.2010.09.018

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…Recently, minute neuroendocrine tumors arising on the duct wall (especially from serotonin cells) are coming to clinical attention, and may clinically mimic an IPMN as they can cause significant ductal dilatation. 162, 163 More importantly, on rare occasions, small PDACs can lead to marked dilatation of the main duct, again clinically mimicking an IPMN. In these cases the obstructive carcinoma can be missed.…”

Section: Resultsmentioning

confidence: 99%

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Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract

et al. 2016

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Background There are no established guidelines for pathologic diagnosis/reporting of IPMNs. Design An international multidisciplinary group brought together by the Verona Pancreas Group in Italy-2013, was tasked to devise recommendations. Results 1) Crucial to rule out invasive carcinoma with extensive (if not complete) sampling. 2) Invasive component is to be documented in a full synoptic report including its size, type, grade, stage. 3) The term “minimally invasive” should be avoided; instead, invasion size with stage and substaging of T1 (1a, b, c; ≤0.5, >0.5–≤1, >1 cm), is to be documented. 4) Largest diameter of the invasion, not the distance from the nearest duct, is to be used. 5) A category of “indeterminate/(suspicious) for invasion” is acceptable for rare cases. 6) The term “malignant” IPMN should be avoided. 7) The highest grade of dysplasia in the non-invasive component is to be documented separately. 8) Lesion size is to be correlated with imaging findings in cysts with rupture. 9) The main duct diameter, and if possible, its involvement is to be documented; however, it is not required to provide main vs branch duct classification in the resected tumor. 10) Subtyping as gastric/intestinal/pancreatobiliary/oncocytic/mixed is of value. 11) Frozen section is to be performed highly selectively, with appreciation of its shortcomings. 12) These principles also apply to other similar tumoral intraepithelial neoplasms (mucinous cystic neoplasms, intra-ampullary, intra-biliary/cholecystic). Conclusion These recommendations will ensure proper communication of salient tumor characteristics to the management teams, accurate comparison of data between analyses, and development of more effective management algorithms.

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Section: Resultsmentioning

confidence: 99%

“…Sampling of seemingly uninvolved pancreas can also reveal subtle, grossly-unapparent obstructive lesions that lead to “pseudo-IPMN” 162 .…”

Section: Resultsmentioning

confidence: 99%

Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract

et al. 2016

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“…Several pancreatic diseases, such as neuroendocrine tumours and acinar cell carcinomas, can cause dilatation or cystic formation of the pancreatic duct, mimicking IPMN [10, 11]. However, there is no previous report of a case of combined SCN and PanIN mimicking IPMN, as in our present case.…”

Section: Discussionmentioning

confidence: 59%

A Serous Cystic Neoplasm of the Pancreas Coexisting with High-Grade Pancreatic Intraepithelial Neoplasia Mimicking an Intraepithelial Papillary Mucinous Neoplasm: A Case Report

et al. 2017

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Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct. Furthermore, communication between the cystic lesion and the main pancreatic duct was suspected based on magnetic resonance pancreatography findings. Distal pancreatectomy was performed under the preoperative diagnosis of intraductal papillary mucinous neoplasm. Histologically, the cystic lesion was lined with a non-atypical cuboidal or flat epithelium with clear cytoplasm and was thus diagnosed as a serous cystic neoplasm. High-grade PanIN lesions with stromal fibrosis were observed at the main and branch pancreatic ducts. Histological examination revealed no communication between the serous cystic neoplasm and the pancreatic ducts. Immunohistochemically, the epithelium of the serous cystic neoplasm showed positive anti-von Hippel-Lindau antibody staining, whereas the epithelium of the PanIN showed negative staining. A serous cystic neoplasm coexisting with another pancreatic neoplasm is rare. When dilatation of the main or branch pancreatic ducts coexists with a serous cystic neoplasm, as in this case, the lesion clinically mimics an intraductal papillary mucinous neoplasm.

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“…Somatostatin-positive NF-PanNETs may show paraganglioma-like pattern with glandular structures and psammoma bodies [54]. Serotonin-positive NF-PanNETs may show small cell nests and tubules within dense stromal sclerosis arising adjacent to the main duct, causing duct obstruction and dilatation [55,56]. Staging of NF-PanNETs follows the (UICC) TNM classification and the American Joint Committee on Cancer (AJCC) cancer staging.…”

Section: Pancreas -Introductionmentioning

confidence: 99%

Histopathologic Diagnosis of Neuroendocrine Neoplasms of Head and Neck, Lung and Gastrointestinal Tract

Bonestroo¹,

Racila²

2023

Advances in Fine Needle Aspiration Cytopathology

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Neuroendocrine neoplasms are classified as epithelial and non-epithelial based on their origin being from epithelial neuroendocrine progenitor cells or derived from the neural crest. The latter are negative for cytokeratin (hence non-epithelial) and mostly result from neoplastic transformation of paraganglia. Here, we are reviewing the most important histologic and immunophenotypic characteristics of neuroendocrine carcinomas as well as the current WHO classification guidelines. The terminology of neuroendocrine neoplasms is confusing due to various classification systems employed for each internal organ. In the lung and GI tract, for example, “neuroendocrine tumors” comprise carcinomas of different degree of differentiation and histologic grade. While in the lung the term refers strictly to low-grade neuroendocrine carcinomas, in the GI tract it comprises both low- and high-grade neuroendocrine carcinomas. Despite concerted efforts to unify the overall classification of neuroendocrine carcinomas across organs, major differences continue to persist.

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Pseudointraductal papillary mucinous neoplasia caused by microscopic periductal endocrine tumors of the pancreas: a report of 3 cases

Cited by 10 publications

References 12 publications

Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract

Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract

A Serous Cystic Neoplasm of the Pancreas Coexisting with High-Grade Pancreatic Intraepithelial Neoplasia Mimicking an Intraepithelial Papillary Mucinous Neoplasm: A Case Report

Histopathologic Diagnosis of Neuroendocrine Neoplasms of Head and Neck, Lung and Gastrointestinal Tract

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