Solid Pseudopapillary Neoplasms of the Pancreas: Clinicopathologic and Radiologic Features According to Size

Robertis, Riccardo De; Marchegiani, Giovanni; Catania, Matteo; Ambrosetti, Maria Chiara; Capelli, Paola; D’Onofrio, Mirko

doi:10.2214/ajr.18.20715

Cited by 34 publications

(38 citation statements)

References 23 publications

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“…[23][24][25][26][27] However, one study indicated that there was no significant correlation between the malignant potential of SPNs and tumor size. 28 The difference may be related to the number of samples, particularly the small sample size of the patients with aggressive SPN biological behaviors and poor prognosis. In the current study, nine patients showed aggressive SPN biological behavior, of whom three had local recurrence and six had metastases.…”

Section: Discussionmentioning

confidence: 99%

Solid-Pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Chen¹,

Huang

Yang

et al. 2021

CMAR

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Purpose Solid-pseudopapillary neoplasm (SPN) of the pancreas, a rare tumor, has low malignant potential. However, some patients develop metastasis and recurrence after resection, with aggressive biological behaviors. This study aimed to explore the features and risk factors associated with the aggressive biological behaviors of SPNs. Patients and Methods We retrospectively analyzed the clinicopathological and long-term follow-up data of 63 patients diagnosed with SPN at the First Affiliated Hospital of Bengbu Medical College between January 2007 and February 2019. Results Sixty-three patients presented atypical clinical symptoms. The median tumor size was 7.0 cm (range, 2.4–17 cm), and imaging features were solid and cystic or solid tumors with uneven density. Frequent and diffuse nuclear LEF1 protein expression (94.2%) was observed with LEF1 having a higher sensitivity and specificity. Overall survival significantly correlated with tumor size, Ki-67 index, and lymph node metastasis ( P < 0.05). Conclusion SPN is a rare low-grade malignancy with a specific pseudopapillary structure. LEF1 is an effective biomarker of SPNs. Although SPNs generally display indolent biological behavior, a large tumor size, high proliferation index, and lymph node metastasis may be risk factors for the aggressive behavior and poor prognosis of SPN.

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Section: Discussionmentioning

confidence: 99%

Solid-Pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Chen¹,

Huang

Yang

et al. 2021

CMAR

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“…1 Preoperative diagnostic imaging of SPNs is challenging owing to considerable morphological overlap with pancreatic diseases of particular aggressiveness, treatment and prognosis, specifically non-functioning neuroendocrine tumours (np-NET), serous cystadenoma and, rarely, ductal adenocarcinoma. 2,5,6 Therefore, histopathological evaluation of suspicious lesions is necessary. Considering its high diagnostic accuracy for the detection of ductal adenocarcinoma, 7 endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) could be a useful minimally invasive and reliable diagnostic modality for SPN.…”

Section: Introductionmentioning

confidence: 99%

“…Preoperative diagnostic imaging of SPNs is challenging owing to considerable morphological overlap with pancreatic diseases of particular aggressiveness, treatment and prognosis, specifically non‐functioning neuroendocrine tumours (np‐NET), serous cystadenoma and, rarely, ductal adenocarcinoma 2,5,6 . Therefore, histopathological evaluation of suspicious lesions is necessary.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of pancreatic solid pseudopapillary neoplasms using cell‐blocks and immunohistochemical evaluation of endoscopic ultrasound‐guided fine needle aspiration biopsy specimens

et al. 2020

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Introduction: Preoperative diagnostic imaging of pancreatic solid pseudopapillary neoplasms (SPNs) is challenging. A few studies have investigated the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of SPN. We investigated the diagnostic yield of cell-blocks and immunohistochemistry (IHC) for SPN using EUS-FNA specimens without cytological evaluation. Patients and methods: We retrospectively analysed the histopathology records of patients with suspected SPN, who underwent EUS-FNA biopsy between January 1997 and January 2020. Diagnosis based on cell-blocks (haematoxylin-eosin staining with complementary IHC) was compared with the definitive surgical diagnosis. Results: This study included 25 patients (24 were women). Patients' mean age was 33.7 years (range 12-78 years). The most common symptom was abdominal pain. SPN was an incidental finding in 52% of the patients. The mean lesion size was 4.3 cm (range 1.2-11.4 cm), and the most common endosonographic features included solidcystic (56%) or solid (40%) tumours. Final diagnoses included SPNs (n = 23) and nonfunctioning neuroendocrine tumours (n = 2). The overall accuracy of EUS-FNA was 80%. Tumour cells showed immunopositivity for β-catenin, CD10, CD99 and progesterone receptor (PR) in 93.7%, 87.5%, 83.3% and 66.6% of patients, respectively. No SPN showed immunopositivity for chromogranin A. Conclusions: Intention-to-diagnose analysis showed that the diagnostic accuracy of EUS-FNA for SPNs using cell blocks and complementary IHC without cytological evaluation was fairly good. Evaluation of β-catenin, CD 10, CD99 and PR expression must be included in the IHC panel for diagnostic confirmation of SPNs using EUS-FNA biopsy specimens.

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“…There are also reports that male sex, incomplete capsules, a young age (< 13.5 years), positive surgical margins during the initial tumor resections, and large tumor sizes may be associated with SPN recurrence [23][24][25][26][27]. However, one study indicated that there was no significant correlation between the malignant potential of SPNs and tumor size [28]. The difference may be related to the number of samples, particularly the small sample size of the patients with aggressive SPN biological behaviors and poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Solid-pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Chen

Huang

Yang

et al. 2021

Preprint

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Background:Asolid-pseudopapillary neoplasm (SPN) of the pancreas, a rare tumor, has low malignant potential. However, some patients develop metastasis and recurrence after resection, with aggressive biological behaviors of SPNs. This study aimedtoexplorethefeatures andriskfactors associated withtheaggressivebiological behaviorsofSPNs.Materials and Methods: We retrospectively analyzed the clinicopathological and long-term follow-up data of 63 patients with SPN diagnosed at the First Affiliated Hospital of Bengbu Medical College between January 2007 and February 2019.Results: The 63 patients presented with atypical clinical symptoms. The mean tumor size was 7.2 cm (range, 2.4–17 cm), and imaging features were solid and cystic or solid tumors with uneven density. Frequent and diffuse nuclear LEF1 expression (94.2%) was observed with LEF1 having a higher sensitivity and specificity. Overall survival significantly correlated with tumor size, Ki-67 index, and lymph node metastasis(P<0.05).Conclusions: SPN is a rare low-grade malignancy with a specific pseudopapillary structure. LEF1 is an effective biomarker of SPNs. Although SPNs generally display indolent biological behavior, a large tumor size, high proliferation index and lymph node metastasis may be risk factors for the aggressive behavior and poor prognosis of anSPN.

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Solid Pseudopapillary Neoplasms of the Pancreas: Clinicopathologic and Radiologic Features According to Size

Cited by 34 publications

References 23 publications

Solid-Pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Solid-Pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

Diagnosis of pancreatic solid pseudopapillary neoplasms using cell‐blocks and immunohistochemical evaluation of endoscopic ultrasound‐guided fine needle aspiration biopsy specimens

Solid-pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy

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