Endoscopic Ultrasound–Guided Fine-Needle Aspiration Cytology Diagnosis of Solid-Pseudopapillary Tumor of the Pancreas

Bardales, Ricardo H.; Centeno, Barbara A.; Mallery, J. Shawn; Lai, Rebecca; Pochapin, Mark; Guiter, Gerardo; Stanley, Michael W.

doi:10.1309/dkk2b9v4n0w26a8q

Cited by 137 publications

(35 citation statements)

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“…EUS of SPN shows a well-demarcated cystic lesion with a solid component and may have calcification within the cyst. Occasionally these lesions can present as purely cystic or purely solid lesions [16,17]. At our institution, duplicate smears are made in the endoscopy suite; one is stained with Romanowsky's stain for on-site evaluation of adequacy (OSEA) [18], and the other is fixed in 95% alcohol for Papanicolaou staining.…”

Section: Endoscopy and Fine-needle Aspirationmentioning

confidence: 99%

“…The genes commonly mutated in other neoplasms of the pancreas, including KRAS , TP53 SMAD4 , GNAS , RNF43 , p16 and VHL , are not targeted in SPN [2,3,10,11]. Losses of heterozygosity are not common, and most SPNs are diploid [16,28]. …”

Section: Molecular Studiesmentioning

confidence: 99%

“…[8,9,29]. A few studies have suggested a poor prognosis in males; however, larger studies have disputed this association [2,5,7,8,15,16,22,30,31]. Also, the malignant potential of SPN found in children is not significantly different from that in adults [29].…”

Section: Clinical Managementmentioning

confidence: 99%

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Solid-Pseudopapillary Neoplasm of the Pancreas: Cytomorphologic Findings and Literature Review

Bhatnagar

Olson²,

Fishman³

et al. 2014

Acta Cytologica

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Background: Solid-pseudopapillary neoplasm (SPN) is a rare pancreatic malignancy with an excellent prognosis. It is most commonly diagnosed in young women. This article comprehensively reviews the clinical, pathological and radiological features of this neoplasm, as well as its clinical management. Methods: A literature review of SPN was performed of all articles published in the English language in PubMed prior to November 1, 2013. Cytomorphological features, histopathology, immunohistochemistry, patient general demographics, molecular studies, radiologic imaging and clinical management were reviewed. Results: SPN displays distinct cytomorphological features on fine-needle aspiration - thin, delicate, branching vessels in a ‘Chinese character' pattern lined by one to several layers of loosely cohesive neoplastic cells. Nuclear features include indented or grooved nuclei with an evenly distributed chromatin pattern and small inconspicuous nucleoli. SPN is characteristically immunoreactive for CD10, β-catenin (in an abnormal nuclear pattern), CD99 in a perinuclear dot-like pattern, α1-antitrypsin, and progesterone receptor. Almost all SPNs harbor an activating point mutation in exon 3 of the β-catenin gene (CTNNB1). Clinicopathological features generally do not correlate with prognosis, and most patients experience excellent long-term survival. Conclusions: SPN can mimic other neoplasms of the pancreas, which can lead to diagnostic challenges in a limited cytologic specimen. Distinct cytomorphological features can help distinguish SPNs from other pancreatic neoplasms. Complete surgical resection as well as resection of metastatic disease is preferred given a low rate of tumor recurrence and long periods of disease-free intervals.

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Section: Endoscopy and Fine-needle Aspirationmentioning

confidence: 99%

Section: Molecular Studiesmentioning

confidence: 99%

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Solid-Pseudopapillary Neoplasm of the Pancreas: Cytomorphologic Findings and Literature Review

Bhatnagar

Olson²,

Fishman³

et al. 2014

Acta Cytologica

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“…2 The WHO pancreatic tumor working group recently recommended the use of the term solid-pseudopapillary neoplasm, 3 a term that has been widely used and accepted by pathologists and clinicians in daily practice. 4,5 Recent work by Cao et al 6 suggested that this tumor utilizes different genetic pathways from the more common pancreatic ductal adenocarcinomas.…”

mentioning

confidence: 99%

Solid-pseudopapillary Neoplasm of the Pancreas

Liu

Rauch

Siegal³

et al. 2006

Applied Immunohistochemistry &Amp; Molecular Morphology

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Solid-pseudopapillary neoplasm of the pancreas is a very rare tumor. It most commonly occurs in young women and has unique pathologic features. Previous immunohistochemical studies demonstrated that most solid-pseudopapillary neoplasms were immunoreactive with antibodies directed against vimentin and neuron-specific enolase. Recently, expression of CD10 and CD56 in this tumor has been reported. In this report, we expanded the demographic profile, highlighting 3 cases of solid-pseudopapillary neoplasm of the pancreas that presented in an elderly woman, a young man, and a young woman and further characterized them histologically and immunophenotypically. Grossly, all 3 tumors were well circumscribed and had a variable degree of cystic formation, necrosis, and hemorrhage. Microscopically, these tumors were characterized by a pseudopapillary pattern of epithelioid cells arranged around a delicate fibrovascular core with sheets of bland epithelioid cells filling cystic spaces. Hyaline globules, cholesterol granulomas, and foamy cells were all seen to be common findings. Although these 3 tumors were strongly immunoreactive for vimentin, alpha-1-antitrypsin, alpha-1-antichymotrypsin, neuron-specific enolase, CD10, CD56, and progesterone receptor, they demonstrated only variable "positivity" for epithelial membrane antigen and broad-spectrum cytokeratin, but were being consistently nonreactive for synaptophysin, insulin, glucogon, chromogranin A, and estrogen receptor. Interestingly, 2 of the 3 tumors were S-100 protein and melanin A reactive but were nonreactive for HMB45.

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“…Jani reports a 75% efficacy (21/28 cases) with FNA guided in EUS exploration and points out the value of the immunohistochemical study in the cytology (35,36).…”

Section: Methodsmentioning

confidence: 99%

Solid pseudopapillary tumor of the pancreas (SPPT): Still an unsolved enigma

Cienfuegos

Lozano

Rotellar

et al. 2010

Rev. esp. enferm. dig.

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Solid pseudo-papillary tumor (SPPT) is a rare cystic tumor of the pancreas (1-3% of exocrine tumors of the pancreas) which shows an "enigmatic" behavior on the clinical and molecular pattern. A retrospective analysis of the citological studies and resected specimens of pancreatic cystic tumors from May 1996 to February 2010 was carried out. Three cases of SPPT were found, which are the objective of this study. The diagnosis was established upon occasional finding in the abdominal CT, in spite of sizing between 3 and 6 cm of diameter. In the three cases the preoperative diagnosis was confirmed by citology and specific immunohistochemical staining. Cases 2 and 3 showed strong immunoreactivity for Beta-Catenina and E-Cadherina staining. Radical resection (R0) was carried out in the three cases. A young male -21 years of age (case 1)-who had duodenal infiltration and two lymph nodes metastases died of hepatic and peritoneal recurrence 20 months following surgery. The other two cases are free of disease. The current review of the literature reports roughly 800 cases since the first report in 1959, and shows the enigmatic character of this tumor regarding the cellular origin, molecular pathways, prognostic factors and clinical behavior.Key words: Solid-pseudopapillary tumor. Pancreatic cystic neoplasm. Prognosis. Beta-catenina. RESUMENEl tumor pseudopapilar (TSPP) es un tumor quístico del pán-creas muy poco frecuente (1-3% de los tumores exocrinos del páncreas) y que tiene un comportamiento oncológico y molecular "enigmático". Se realizó un análisis retrospectivo de las citologías de las lesiones quísticas del páncreas, así como de los tumores quísticos resecados entre mayo de 1996 y febrero de 2010, encontrándose tres tumores SSPP, motivo de este estudio. En los tres casos el diagnóstico fue ocasional en el TC abdominal a pesar de presentar unos tamaños entre 3 y 6 cm de diámetro. En los tres casos se confirmó el diagnóstico preoperatorio mediante citología e inmunohistoquímica. En los casos 2 y 3 se confirmó la positividad para Beta-Catenina y E-Cadherina. En todos los casos se realizó cirugía radical (R0). Un varón de 21 años -caso 1-que presentaba infiltración duodenal y metástasis ganglionares falleció de progresión hepática y peritoneal a los veinte meses de la cirugía. Las otras dos pacientes -casos 2 y 3-se encuentran libres de recidiva. La revisión de la literatura desde su descripción en 1959 hasta la actualidad -aproximadamente 800 casos-confirma el carácter enigmático de este tumor en relación a su origen celular, molecular, factores pronósticos y comportamiento clínico.Palabras clave: Tumor sólido-pseudopapilar, Tumores quísti-cos de páncreas. Pronóstico.

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Endoscopic Ultrasound–Guided Fine-Needle Aspiration Cytology Diagnosis of Solid-Pseudopapillary Tumor of the Pancreas

Cited by 137 publications

References 0 publications

Solid-Pseudopapillary Neoplasm of the Pancreas: Cytomorphologic Findings and Literature Review

Solid-Pseudopapillary Neoplasm of the Pancreas: Cytomorphologic Findings and Literature Review

Solid-pseudopapillary Neoplasm of the Pancreas

Solid pseudopapillary tumor of the pancreas (SPPT): Still an unsolved enigma

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