Metastatic papillary oncocytic carcinoma of the pancreas to the liver diagnosed by fine-needle aspiration

Thompson, Karen; Castelli, Melanie J.; Gattuso, Paolo

doi:10.1002/(sici)1097-0339(199804)18:4<291::aid-dc9>3.0.co;2-f

Cited by 14 publications

(15 citation statements)

References 18 publications

(28 reference statements)

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“…Although the cytologic features of IPMNs are well established, the cytologic features of IOPNs (oncocytic‐type IPMNs) are described only rarely and mainly in isolated reports . This is probably related in part to the rarity of the entity, but it is also somewhat attributable to a lack of recognition, which we hope the current study will alleviate to some degree.…”

Section: Discussionmentioning

confidence: 99%

Cytopathologic diagnosis of oncocytic type intraductal papillary mucinous neoplasm: Criteria and clinical implications of accurate diagnosis

Reid

Stallworth

Lewis

et al. 2015

Cancer Cytopathology

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BACKGROUND Cytologic findings of pancreatic oncocytic-type intraductal papillary mucinous neoplasms (IPMNs)/intraductal oncocytic papillary neoplasms (IOPNs) are largely unknown. METHODS Five IOPNs encountered by the authors were analyzed. RESULTS Four IOPNs were located in the pancreatic head, and 1 was located in the pancreatic body/tail in 2 men and 3 women ages 56 to 84 years (mean age, 66 years). Radiologic diagnoses included pancreatic ductal adenocarcinoma (PDAC) in 2 patients, invasive cancer associated with IPMN in 1 patient, IPMN versus mucinous cystic neoplasm in 1 patient, and cystic mass in 1 patient. Cytologic findings included: hypercellular smears (4 of 5 cases) containing well formed clusters of oncocytic cells (5 of 5 cases) with prominent, slightly eccentric nucleoli (4 of 5 cases), predominantly arranged in sheets/papillary units (5 of 5 cases), with punched-out intercytoplasmic spaces (4 of 5 cases), and with occasional 3-dimensional groups and focal necrosis (3 of 5 cases). The intracytoplasmic mucin and thick extracellular mucin typical of other IPMNs were observed only in 2 cases and were very limited. The mean size on resection was 4.5 cm. Invasion was observed in 3 cases (0.1, 0.3, and 2.0 cm) of tubular-type IPMN. Initial cytologic evaluation was performed by the authors in 4 of 5 cases, which were diagnosed as IOPN (n = 3) and IPMN versus cystic PDAC (n = 1). One case was initially misdiagnosed as PDAC and, on resection, proved to be noninvasive IOPN. CONCLUSIONS Cytologic features of IOPNs are classical, similar to their histologic counterparts, and differ significantly from other IPMN subtypes. Because of their highly complex appearance, they are often radiologically misdiagnosed as PDAC; thus, failure to recognize their characteristic features on fine-needle aspiration may lead to inappropriate treatment. Patients with IOPN have an incomparably better prognosis than patients with ordinary PDAC, even when their neoplasms are invasive.

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Section: Discussionmentioning

confidence: 99%

Cytopathologic diagnosis of oncocytic type intraductal papillary mucinous neoplasm: Criteria and clinical implications of accurate diagnosis

Reid

Stallworth

Lewis

et al. 2015

Cancer Cytopathology

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“…32,33 Since the IOPN entity was first described by Adsay et al in 1996, only 31 cases have been reported. 3,[7][8][9][10][11][12][13][14][15][16][17][18][19][20] The average age of patients was 63.0 years (range, 37-79 years), and the male : female ratio was 1.1:1. Most IOPN were located in the pancreatic head (60.0%), and the average tumor size was 6.40 cm (range, 1.69-15.0 cm).…”

Section: Discussionmentioning

confidence: 99%

Intraductal oncocytic papillary carcinoma of the pancreas showing numerous hyaline globules in the lumen

Tajiri

Inagaki

Ohike

et al. 2009

Pathology International

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Two cases of intraductal oncocytic papillary carcinoma (IOPC) treated surgically were analyzed on light microscopy and immunohistochemistry: that of a 61-year-old man and that of a 55-year-old man. There were no clinical symptoms in either case. Pancreatic abnormalities were discovered incidentally on CT. Various clinical examinations were carried out, and the preoperative diagnosis was intraductal papillary mucinous carcinoma (IPMC) in both cases. Surgery was performed. Macroscopic observation of tissue cross-sections indicated multilocular cystic mass containing polypoid lesions encapsulated by the dilated pancreatic duct. Histologically, the cyst walls were lined by columnar epithelial cells with complex papillary projections associated with oxyphilic cytoplasm, and they were strongly immunoreactive with anti-mitochondrial antibody in the cytoplasm. Electron microscopy showed numerous mitochondria in the cytoplasm. IOPC was diagnosed. Interestingly, amorphous hyaline globules were produced from the oxyphilic cells, which exhibited a bud-like appearance. The hyaline globules were not positive for mucin staining. No case of IPMC with hyaline globules has been reported to date. The production of hyaline globules may be related to oncocytic differentiation. It is suggested that hyaline globules should be regarded as a characteristic of IOPC.

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“…Of the total 14 patients reported in the literature, recurrence was noted in 1, metastases developed in 1, 3 died postoperatively, 1 died of other causes, and 8 were alive with no evidence of disease (Table 1). [9][10][11] However, there are insufficient data in the literature to determine the clinical course of intraductal oncocytic papillary neoplasm, although the biological behavior of this tumor seems to be better than that of ductal carcinoma. We recently described the clinicodiagnostic features of malignant and benign intraductal papillary tumors of the pancreas to assist us in the selection of appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Intraductal Oncocytic Papillary Neoplasm of the Pancreas with Celiac Artery Compression Syndrome and a Jejunal Artery Aneurysm: Report of a Case

et al. 2005

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A 79-year-old woman presented with epigastralgia, and computed tomography showed a 3-cm multiloculated mass with a mural nodule in the head of the pancreas. Arteriography showed stenosis of the celiac artery and a saccular aneurysm, arising from the first jejunal artery. We made a preoperative diagnosis of intraductal papillary adenocarcinoma of the pancreatic head and performed a laparotomy. Transection of the median arcuate ligament failed to restore adequate hepatic blood flow, necessitating construction of celiac vascularization, achieved by a gastroduodenal to jejunal artery anastomosis. After ligation of the jejunal artery aneurysm, we performed a pylorus-preserving pancreaticoduodenectomy. Microscopically, the tumor had papillary intracystic growth, and was lined by plump cells with abundant eosinophilic cytoplasm, consistent with a diagnosis of intraductal oncocytic papillary neoplasm. We discuss this recently recognized entity of papillary neoplasm of the pancreas, and the importance of managing hepatic blood flow during pancreaticoduodenectomy in celiac artery compression syndrome.

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Metastatic papillary oncocytic carcinoma of the pancreas to the liver diagnosed by fine-needle aspiration

Cited by 14 publications

References 18 publications

Cytopathologic diagnosis of oncocytic type intraductal papillary mucinous neoplasm: Criteria and clinical implications of accurate diagnosis

Cytopathologic diagnosis of oncocytic type intraductal papillary mucinous neoplasm: Criteria and clinical implications of accurate diagnosis

Intraductal oncocytic papillary carcinoma of the pancreas showing numerous hyaline globules in the lumen

Intraductal Oncocytic Papillary Neoplasm of the Pancreas with Celiac Artery Compression Syndrome and a Jejunal Artery Aneurysm: Report of a Case

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