Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas

Maire, Frédérique; Hammel, Pascal; Terris, Benoı̂t; Vilgrain, Valérie; O’Toole, Dermot; Lévy, Philippe; Belghiti, Jacques; Ruszniewski, Philippe

doi:10.1159/000049452

Cited by 7 publications

(3 citation statements)

References 15 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Inflammation may also impart a more complex architecture to an otherwise simple mucinous cystic neoplasm and raise the suspicion of malignancy. 114 Mucinous cystic neoplasms can show a wide range of cytologic and architectural atypia: Some are histologically bland, with uniform, basally oriented nuclei, and minimal architectural atypia, while others exhibit prominent papillary proliferations that form intraluminal polypoid masses with cribriform architecture and substantial cytologic atypia ( Figure 11). The epithelial atypia may be patchy, and there is often an abrupt transition between histologically bland epithelium and epithelium with severe atypia.…”

Section: Mucinous Cystic Neoplasmsmentioning

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

Section: Mucinous Cystic Neoplasmsmentioning

confidence: 99%

Cystic lesions of the pancreas

Adsay

2007

Modern Pathology

191

View full text Add to dashboard Cite

show abstract

“…This finding is not surprising because MCNs histologically are known to be associated with inflammation and denuding. 4,5 The denuding of MCNs may histologically appear similar to a pseudocyst, and the associated inflammation may mistakenly raise suspicion of malignancy. 5 Furthermore, MCNs typically occur in middleaged women and are lined by epithelium resembling endocervical epithelium.…”

mentioning

confidence: 99%

“…4,5 The denuding of MCNs may histologically appear similar to a pseudocyst, and the associated inflammation may mistakenly raise suspicion of malignancy. 5 Furthermore, MCNs typically occur in middleaged women and are lined by epithelium resembling endocervical epithelium. They are most importantly associated with ovarian stroma that routinely express progesterone and estrogen receptors.…”

mentioning

confidence: 99%