Tumor-Suppressing Pathways in Cystic Pancreatic Tumors

Gerdes, Berthold; Wild, Anja; Wittenberg, Judith; Barth, Peter; Ramaswamy, Annette; Kersting, Michael; Lüttges, Jutta; Klöppel, Günter; Bartsch, Detlef K.

doi:10.1097/00006676-200301000-00008

Cited by 42 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The cells lining the small cysts have clear cytoplasm with well-defined border and round uniform nuclei. They are negative for mucin stains; in these, lesions are not present the molecular genetic alterations, specific of mucinous-type ductal pancreatic neoplasia such as mutation in the K-ras, SMADH4/DPC4, TP53, and p16 genes [13]. In the pathogenesis of serous cystadenomas, the alterations of von Hippel-Lindau (VHL) gene have been demonstrated in 40% of cases [3]; therefore, serous cystadenomas are associated with von Hippel-Lindau syndrome, an autosomal dominant disorder, characterized by hemangioblastoma of central nervous system and retina, renal cysts and neoplasms, and phaeochromocytomas.…”

Section: Serous Cystic Neoplasms (Scns)mentioning

confidence: 99%

Management of Pancreatic Cystic Lesions

Neri¹

2017

Challenges in Pancreatic Pathology

View full text Add to dashboard Cite

Objectives: In the last several decades, the knowledge of the cystic neoplasms has enlarged and the management has changed. The wide adoption in the diagnostic procedures of routine and advanced imaging has become the cornerstone of the diagnosis.Methods: Pancreatic cystic tumors comprise neoplasms with a wide range of malignant potential. The most common include serous cystic neoplasm, mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), solid pseudopapillary neoplasms (SPPNs), and cystic pancreatic endocrine neoplasms (CPENs). Other cystic lesions are acute postnecrotic pseudocysts and chronic pseudocysts. Finally, the indeterminate cystic lesions have been presented. Results:The epidemiology, pathological features, imaging characteristics, clinical evolution, and therapeutic choices of the most frequent lesions as well as less frequent forms are described. This study can be completed with the presentation of some cases of cystic pancreatic neoplasms treated in our service. Conclusion:The improvement of imaging, endoscopic modalities, and cyst fluid studies allows now accurate and reliable diagnosis of pancreatic cystic lesions. Moreover, the enlarged knowledge of valuable pathological studies established the potential for malignant transformation of these lesions identifying higher-risk neoplasms. Finally, the management options should be based on the assessment of each type of cystic neoplasms and the distinction of pancreatic cystic neoplasms (PCNs) from other cystic lesions.

show abstract

Section: Serous Cystic Neoplasms (Scns)mentioning

confidence: 99%

Management of Pancreatic Cystic Lesions

Neri¹

2017

Challenges in Pancreatic Pathology

View full text Add to dashboard Cite

show abstract

“…[53][54][55][56][57][58] Detection of these underlying molecular changes using cyst fluid DNA derived from exfoliated epithelial cells in a small volume of fluid has become a focus of active research. The group from the University of Pittsburgh subjected cyst fluid obtained from EUS-guided FNA to DNA extraction followed by polymerase chain reaction amplification.…”

Section: Molecular Analysis Of Cyst Fluidmentioning

confidence: 99%

Pancreatic cysts

Pitman

Lewandrowski

Shen

et al. 2010

Cancer Cytopathology

125

View full text Add to dashboard Cite

Preoperative diagnosis of pancreatic cysts benefits from integrating the clinical, radiological, and cytological features. As patient management algorithms evolve to increasingly nonsurgical options, accuracy in distinguishing mucinous from nonmucinous and benign from malignant mucinous cysts is important. This review focuses on pseudocysts, serous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms. Patients with pseudocysts almost always present with pancreatitis and are usually medically managed. Radiological studies reveal a unilocular cyst mostly in the pancreatic tail. Cyst fluid is thin, with high amylase but low carcinoembryonic antigen (CEA) levels. DNA mutations are absent. Serous cystadenomas are benign and do not require resection. Patients are usually asymptomatic and have microcystic or macrocystic masses anywhere in the pancreas. Cytology is frequently nondiagnostic. CEA and amylase levels are low. DNA analysis may reveal loss of heterozygosity (LOH) at 3p if associated with Von Hippel-Lindau disease. Neoplastic mucinous cysts are highly variable in their presentation. Most are resected. Mucinous cystic neoplasms typically arise in the body or tail of the pancreas of middle-aged women and demonstrate a septated cyst without dilatation of the main pancreatic duct. Branch duct IPMNs are more common in the pancreatic head of elderly men. Main duct dilatation correlates with main duct or combined type IPMN. Both types of mucinous cysts produce variable amounts of mucin. Cytologically nonmalignant but atypical epithelial cells, even when scant, are an indication of a high risk for malignancy. High CEA level supports a mucinous cyst, as do KRAS mutation and good quality DNA levels. KRAS mutation and multiple LOH support malignancy.

show abstract

“…They do not harbor the molecular genetic alterations that are characteristic of mucinous-type ductal neoplasia of the pancreas, such as mutations in the k-ras, SMADH4/DPC4, TP53, and p16 genes. 138,139 Instead, von Hippel-Lindau gene alterations, detected in 40% of the cases 137,140 have been implicated in the pathogenesis of serous cystadenomas. Glut-1, a molecule involved in glycogen metabolism, is also expressed consistently in serous tumors.…”

Section: Serous Cystadenomamentioning

confidence: 99%

Cystic lesions of the pancreas

Adsay

2007

Modern Pathology

191

View full text Add to dashboard Cite

Although cystic tumors of the pancreas are relatively rare, they constitute an increasingly important category. Advances in imaging and interventional techniques and the sharp drop in the mortality rate of pancreatic surgery have rendered pancreatic biopsies and resections commonplace specimens. Consequently, in the past two decades, the nature of many cystic tumors in this organ has been better characterized. The names of some existing entities were revised; for example, what was known as papillary-cystic tumor is now regarded as solidpseudopapillary tumor. New entities, in particular, intraductal papillary mucinous neoplasm and its variants, such as oncocytic and intestinal subtypes were recognized. The importance of clinical and pathologic correlation in the evaluation of these lesions was appreciated, in particular, with regards to the multifocality of these lesions, their association with invasive carcinomas, and thus their 'preinvasive' nature. Consensus criteria for the distinction of these from the ordinary precursors of adenocarcinoma, the pancreatic intraepithelial neoplasia, were established. The definition of mucinous cystic neoplasms was refined; ovarian-like stroma has now become almost a requirement for the diagnosis of mucinous cystic neoplasia, and defined as such, the propensity of these tumors to occur in perimenopausal women became even more striking. The validity and clinical value of classifying the pancreatic cysts of mucinous type as adenoma, borderline, CIS and invasive have been established. Related to this, the importance of thorough sampling in accurate classification of these mucinous lesions was recognized. Greater accessibility of the pancreas afforded by improved invasive as well as noninvasive modalities has also increased the detection of otherwise clinically silent cystic tumors, which has led to the recognition of more innocuous entities such as acinar cell cystadenoma and squamoid cyst of pancreatic ducts. As the significance of the cystic lesions emerged, cystic forms of otherwise typically solid tumors were also better characterized. Thus, significant developments have taken place in the classification and our understanding of pancreatic cystic tumors in the past few years, and experience with these lesions is likely to grow exponentially in the coming years. Modern Pathology (2007) 20, S71-S93.

show abstract

Tumor-Suppressing Pathways in Cystic Pancreatic Tumors

Abstract: The tumor suppressor genes p16INK4a, p53, and appear to play an important role in the tumorigenesis of MCCs but not SCAs. These molecular data underscore the clinical and histologic differences of serous and mucinous cystic pancreatic tumors.

Cited by 42 publications

References 29 publications

Management of Pancreatic Cystic Lesions

Management of Pancreatic Cystic Lesions

Pancreatic cysts

Cystic lesions of the pancreas

Contact Info

Product

Resources

About