Intraductal tubulopapillary neoplasm of the pancreatic branch duct showing atypical images

Yoshida, Yukio; Matsubayashi, Hiroyuki; Sasaki, Keiko; Kanemoto, Hideyuki; Uesaka, Katsuhiko; Ono, Hiroyuki

doi:10.1111/1751-2980.12242

Cited by 18 publications

(8 citation statements)

References 20 publications

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“…31 Approximately 95% of ITPNs arise in the main pancreatic duct, whereas a small number arises in branch ducts. 32 The size of ITPN ranges from 1 to 15 cm (average size, 3 cm). Approximately 50% of ITPNs are located in the head of pancreas, 33% in the body and/or tail, and >10% in the pancreatic duct with diffuse involvement.…”

Section: Mucinous Cystic Neoplasmmentioning

confidence: 99%

Pancreatic Ductal Adenocarcinoma and Its Precursor Lesions

Ren

Suriawinata

2019

The American Journal of Pathology

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Pancreatic ductal adenocarcinoma is one of the most aggressive malignant neoplasms with poor outcomes. At the time of diagnosis, the disease is usually at an advanced stage and only a minority is eligible for surgical resection. To improve the prognosis, it is essential to diagnose and treat the disease in an early stage before its progression into an invasive disease. This article reviews clinical features, histopathology, cytopathology, and molecular alterations of pancreatic ductal adenocarcinoma and its precursors. Moreover, we review a recently updated two-tier classification system for precursor lesions, new findings in premalignant cystic neoplasms, and recently updated staging criteria for invasive carcinoma based on the Cancer Staging Manual, eighth edition, from the American Joint Committee on Cancer. Finally, we discuss the potential clinical applications of the rapidly growing molecular and genetic information of pancreatic cancer and its precursors. (Am J Pathol 2019, 189: 9e21; https://

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Section: Mucinous Cystic Neoplasmmentioning

confidence: 99%

Pancreatic Ductal Adenocarcinoma and Its Precursor Lesions

Ren

Suriawinata

2019

The American Journal of Pathology

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“…However, these features are specific to neoplasms of the main pancreatic duct, which is the most common site for pancreatic ITPNs, with reports of branch duct ITPNs being very limited. Yoshida et al reported an ITPN of the pancreatic branch duct which presented as a round, well-circumscribed, weakly enhanced hypovascular mass [ 13 ]. In our case, the cystic masses did not demonstrate typical findings of a main duct ITPN, with their features, in fact, being more consistent of a branch duct ITPN or IPMN.…”

Section: Discussionmentioning

confidence: 99%

Concurrent presentation of an intraductal tubulopapillary neoplasm and intraductal papillary mucinous neoplasm in the branch duct of the pancreas, with a superior mesenteric artery aneurysm: a case report

et al. 2018

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BackgroundSince the concept of intraductal tubulopapillary neoplasm (ITPN) was introduced in the current World Health Organization classification of tumors, the number of reports of ITPN occurrence has increased gradually. However, ITPN is usually located in the main pancreatic duct, with few reports of a branch duct ITPN. As a result, imaging protocols for the diagnosis of a branch duct ITPN have not been established.Case presentationWe report a case of a concurrent presentation of a branch duct ITPN and intraductal papillary mucinous neoplasm (IPMN) in the head of the pancreas, with a superior mesenteric artery (SMA) aneurysm. Initially, the cystic masses in the pancreatic head were diagnosed as branch duct IPMNs, with treatment consisting of a pylorus-preserving pancreaticoduodenectomy, in combination with an aneurysmectomy performed for treatment of the SMA aneurysm. Pathological examination confirmed these cysts were a combination of branch-type ITPN and IPMN. The patient recovered from the treatment without complication, with no evidence of recurrence over a period of 34 months post-surgery.ConclusionThis case report of a synchronous presentation of an ITPN and IPMN indicates the difficulty in differentiating these two types of neoplasms in the branch duct of the pancreatic head.

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“…In the data published (table 1), ITPN showed no sex prediliction, occurred in an age range of 35-80 years and was frequently located in the head and body of the pancreas [1,3,4,5,6,7,8,9,10,11,15]. On imaging studies, it presented as positron emission tomography (PET)-avid, as a cystic mass on computed tomography and as a hypoechoic mass on EUS.…”

Section: Discussionmentioning

confidence: 99%

“…The cytologic findings described in the literature are summarized in table 2 [3,4,5,6,7,8,9,11]. The slides were reported to show moderate-to-hypercellular smears with a background of cyst-type fluid, but no extracellular mucin was noted.…”

Section: Discussionmentioning

confidence: 99%

Intraductal Tubulopapillary Neoplasm of the Pancreas Masquerading as Pancreatic Neuroendocrine Carcinoma: Review of the Literature with a Case Report

Savant

Lee²,

Das³

2016

Acta Cytologica

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Background: Intraductal tubulopapillary neoplasm of the pancreas (ITPN) is a rare tumor which was first described in 2009. We report a case with cytologic and histologic findings and discuss the pitfalls in diagnosing this entity on cytology. Case: An 82-year-old female presented with a pancreatic body mass measuring 3.3 cm. Endoscopic ultrasound-guided fine-needle aspiration showed cells in cohesive clusters with high-grade nuclear atypia. Immunohistochemistry (IHC) showed the neoplastic cells to be positive for CK19, CD56 and chromogranin (focal). Ki-67 was high at 50-60%, and chymotrypsin was negative. On the basis of this pattern of staining, the cytologic diagnosis rendered was ‘favors high-grade neuroendocrine carcinoma'. Distal pancreatic resection revealed a cystic 4-cm mass. Histologically, the tumor was seen arising from the duct with a solid growth pattern, tubule formation and papillary structures. IHC showed the tumor to be negative for chromogranin, synaptophysin, CD56, trypsin and chymotrypsin. The Ki-67 index was 70%. The final diagnosis was noninvasive ITPN. Conclusion: We review the literature and discuss the cytomorphologic features and IHC patterns characteristic of this new entity on cytology material in addition to the pitfalls of the cytologic diagnosis.

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Intraductal tubulopapillary neoplasm of the pancreatic branch duct showing atypical images

Cited by 18 publications

References 20 publications

Pancreatic Ductal Adenocarcinoma and Its Precursor Lesions

Pancreatic Ductal Adenocarcinoma and Its Precursor Lesions

Concurrent presentation of an intraductal tubulopapillary neoplasm and intraductal papillary mucinous neoplasm in the branch duct of the pancreas, with a superior mesenteric artery aneurysm: a case report

Intraductal Tubulopapillary Neoplasm of the Pancreas Masquerading as Pancreatic Neuroendocrine Carcinoma: Review of the Literature with a Case Report

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