Diagnostic challenge: Intraductal neoplasms of the pancreatobiliary system

Tajiri, Takuma; Tate, Genshu; Matsumoto, Koshi; Hoshino, Hiromitsu; Iwamura, Taro; Kodaira, Yuzo; Takahashi, Ken; Ohike, Nobuyuki; Kunimura, Toshiaki; Mitsuya, Toshiyuki; Morohoshi, Toshio

doi:10.1016/j.prp.2012.09.002

Cited by 18 publications

(10 citation statements)

References 22 publications

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“…In the past 29 cases of ITPN, five cases with unusual findings have been reported (Table 1), however there have been no reports of macrophage aggregation. 4,[8][9][10][11] Only one report mentioned a calcified shadow on the CT scan, 4 and in that case there was nodular stromal osseous and cartilaginous mass in the tumor. No cases of ITPN with psammoma bodies have been reported.…”

Section: Discussionmentioning

confidence: 98%

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A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

Takayama

Maeda

Nishihara

et al. 2015

Pathology International

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We experienced a case of intraductal tubulopapillary neoplasms (ITPN) of the pancreas with severe calcification, which complicated image diagnosis. A pancreas head tumor was detected in a Japanese female in her 50s. Early enhancement by contrast-enhanced CT and coarse calcification suggested a neuroendocrine tumor, although the obstruction and dilation of the main pancreatic duct appeared to be an intraductal tumor. An endoscopic ultrasound-guided fine needle aspiration biopsy specimen revealed adenocarcinoma tissue. Pancreaticoduodenectomy was performed, and the patient has been well without evidence of recurrence for over 10 months. Pathological examination on the resected specimen revealed that the tumor showed papillary and tubulo-cribriform growth patterns. Together with typical immunohistochemical results, the final diagnosis of ITPN was made. Characteristically, this case showed extensive calcification of both psammoma body-type and non psammoma body-type with foamy macrophage aggregation. This is the first report of ITPN with two types of calcification and macrophage. Since calcification might be one of the characteristic histological findings in ITPN as shown in our case, the possibility of ITPN should be also considered when calcification is detected in pancreatic lesions by various imaging modalities.

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Section: Discussionmentioning

confidence: 98%

“…[3][4][5][6][7] Cases with atypical histological findings have also been reported. 4,[8][9][10][11] Here we describe the first case of ITPN with duodenal invasion and extensive calcification with foamy macrophage aggregation.…”

mentioning

confidence: 83%

A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

Takayama

Maeda

Nishihara

et al. 2015

Pathology International

View full text Add to dashboard Cite

show abstract

“…Generally, ITPN has similar characteristics as IPMN, especially that of the pyloric gland‐type . Macroscopically, they both show protruding nodules in the pancreatic duct.…”

Section: Discussionmentioning

confidence: 95%

“…Generally, ITPN has similar characteristics as IPMN, especially that of the pyloric gland-type. 2,3 Macroscopically, they both show protruding nodules in the pancreatic duct. Microscopic findings similarly show a tubulopapillary component expand-ing into the lumen.…”

Section: Discussionmentioning

confidence: 99%