Cystic lesions and neoplasms of the pancreas

Klöppel, Günter; Kosmahl, Markus

doi:10.1159/000055876

Cited by 139 publications

(99 citation statements)

References 36 publications

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“…Serous cystic neoplasms are usually solitary neoplasms that mostly occur in middle-aged and elderly women. [1][2][3] Occasionally, they are enlarged and/or multi-centric, and obstruct the pancreatic duct, thereby causing symptoms. 2,4 Furthermore, although serous cystic neoplasms are almost entirely benign, some malignant cases that involve the adjacent organs and/or metastasize to the liver have been reported.…”

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confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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The molecular pathobiology of pancreatic cystic neoplasms is poorly understood. The aim of this study was to know the involvement of epidermal growth factor receptor (EGFR) and its downstream targets in the serous cystic neoplasms and the mucinous cystic neoplasms of the pancreas. In a total of 72 pancreatic cystic neoplasms, including 39 serous cystic neoplasms and 33 mucinous cystic neoplasms, we examined the expression of native and phosphorylated EGFR, mitogen-activated protein kinase (MAPK), and AKT by immunohistochemistry and somatic mutations in EGFR, KRAS, BRAF, and PIK3CA, by direct sequencing. We also assessed the copy numbers of EGFR transcripts and the amplification of the EGFR gene in some of the samples. We found that EGFR, phosphorylated EGFR, MAPK, and phosphorylated MAPK were evidently expressed in 100, 54, 100, and 69% of the serous cystic neoplasms, and in 12%, none, 33, and 27% of the mucinous cystic neoplasms, respectively; the expression was significantly higher and more prevalent in the serous cystic neoplasms than in the mucinous cystic neoplasms. The expression of AKT and phosphorylated AKT was low in both the types of neoplasms. On average, EGFR transcripts in the serous cystic neoplasms and the mucinous cystic neoplasms increased 53.5-and 2.5-fold, respectively, as compared with that in normal tissues, with the increase in the former being significantly greater than that in the latter. Amplification of the EGFR gene was not detected in any of the examined serous cystic neoplasms. None of the tumors had mutations in any of the examined portions of the genes, except two mucinous cystic neoplasms with mutations in codon-12 of KRAS. These results indicate that EGFR and MAPK are actively involved in the pathobiology of serous cystic neoplasms and may therefore be potential diagnostic markers and therapeutic targets in patients with the above mentioned types of neoplasms.

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confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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“…The most common cystic tumors are intraductal papillary-mucinous neoplasms, serous cystic neoplasms, mucinous cystic neoplasms and solid pseudopapillary neoplasms. 2,3 Rare cystic neoplasms include acinar cell cystadenocarcinomas, 4 acinar cell cystadenomas, 5 cystic endocrine tumors 6 and cystic mesenchymal tumors. 7 The differential diagnosis of pancreatic cystic neoplasms, however, also includes pancreatic ductal adenocarcinomas with cystic changes.…”

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confidence: 99%

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

et al. 2005

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Cystic tumors of the pancreas are uncommon but important because of their diverse pathology and biology. Their wide spectrum also includes cystic variants of otherwise solid tumors, such as cystic endocrine tumors, cystic acinar cell carcinomas and ductal adenocarcinomas with cystic changes. In this study, we screened pancreatic ductal adenocarcinomas and their variants for macrocystic changes and determined the nature of the cysts (neoplastic vs non-neoplastic). Of 483 tumors 38 (8%) had cystic features. The largest group consisted of 24 pancreatic ductal adenocarcinomas showing a large-gland pattern with small cysts whose diameter varied between 0.5 and 1.8 cm. The epithelial lining of these cysts was generally positive for CEA (83%) and/or MUC1 (71%) and MUC5AC (74%). p53 was positive in 57% of the cases. The second group of cystic tumors (8/483) showed degenerative cystic cavities with diameters ranging between 1 and 6 cm. This group consisted of poorly differentiated pancreatic ductal adenocarcinomas, undifferentiated carcinomas with or without osteoclast-like giant cells and one adenosquamous carcinoma. In the third group of cystic tumors there were four pancreatic ductal adenocarcinomas containing tumor-related retention cysts. Their epithelial cells were positive for MUC5AC, but negative for CEA, MUC1 and p53. The fourth group consisted of two pancreatic ductal adenocarcinomas showing closely attached pseudocysts caused by tumor-associated pancreatitis. The results indicate that a considerable number of pancreatic ductal adenocarcinomas and their variants display cystic features and must therefore be considered in the differential diagnosis of cystic neoplasms of the pancreas. Moreover, not all of the cystic structures we observed were neoplastic in nature. They may also represent nonneoplastic changes, such as retention cysts and inflammatory pseudocysts.

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“…The predominant neoplastic types are intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystic adenomas, and solid pseudopapillary neoplasms (1). The remaining cystic tumors (the term cystic tumor denotes any cystic lump, regardless of whether it is neoplastic or not) comprise neoplasms, such as acinar cystadenocarcinomas, cystic endocrine tumors, dermoid cysts, and ductal adenocarcinomas with cystic features (2,3).…”

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Mucinous Nonneoplastic Cyst of the Pancreas: A Novel Nonneoplastic Cystic Change?

et al. 2002

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Cystic lesions and neoplasms of the pancreas are uncommon, but they are of special interest because they can usually be cured by resection. During the last decade, the spectrum of these tumors has increased considerably. We present a series of five cystic lesions of the pancreas that differ from all categories described so far. The patients affected by these tumors were three men and two women (mean age, 57 y). Four lesions were unifocal and involved the head of the pancreas; one was multifocal and involved the pancreatic head and tail. Grossly, these tumors presented as unilocular or multilocular thin-walled cysts that contained turbid fluid, or, in two cases, blood, and lacked any communication with the duct system. Microscopically, the cysts were lined by cuboidal to columnar mucin-producing cells, supported by a small band of dense fibrous stroma. Immunocytochemically, the epithelial cells were positive for cytokeratins 7, 8, 18, 19, and 20 (except one), and Ca 19-9 but were negative for trypsin, CEA, synaptophysin, chromogranin A, calretinin, and ␣-inhibin. In four of the five lesions, the epithelial cells expressed MUC5AC, and in one of the five, MUC1. MUC2 and MUC6 were not expressed in any of the lesions. The stromal cells lacked the nuclear progesterone positivity that is typical of mucinous cystic neoplasms. During a mean follow-up period of 2 years, there were no recurrences or cases of malignant transformation after resection. The results suggest that these cystic lesions are distinct from mucinous cystic neoplasms, the most important entity in the differential diagnosis. Because they may represent a nonneoplastic cystic change of the pancreas, we propose the descriptive term mucinous nonneoplastic cyst for these tumors of unknown pathogenesis.

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Cystic lesions and neoplasms of the pancreas

Cited by 139 publications

References 36 publications

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

Mucinous Nonneoplastic Cyst of the Pancreas: A Novel Nonneoplastic Cystic Change?

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