Mucinous pancreatic duct ectasia in the body of the pancreas.

Agostini, S; Choux, R; Payan, Marie-José; Sastre, B.; Sahel, J; Clément, Jean‐Pierre

doi:10.1148/radiology.170.3.2916036

Cited by 70 publications

(11 citation statements)

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“…During the period of this study, the overall number of pancreatic resections per year at our institution has generally increased. Despite reports attributing the IPMN increase to the increased use and improved accuracy of diagnostic imaging, 8,15 this is likely not solely the case, as suggested by the disproportionate increase in IPMNs relative to mucinous cystadenomas, cystadenocarcinomas, and pancreatic ductal adenocarcinomas seen at our institution between 1995 and 2000. Increased recognition of the pathologic entity of IPMN may play some role.…”

Section: Discussionmentioning

confidence: 75%

“…Also, it has been suggested that the observed increase in IPMNs may be partially attributed to improved diagnostic imaging. 8 Several case series of IPMNs have been reported. 7,9 -15 In the current study we present a single-institution, retrospective analysis of the clinical presentation, treatment, pathologic features, and long-term outcome of patients with IPMNs.…”

Section: Resultsmentioning

confidence: 99%

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Intraductal Papillary Mucinous Neoplasms of the Pancreas: An Increasingly Recognized Clinicopathologic Entity

et al. 2001

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ObjectiveTo assess the authors' experience with intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Summary Background DataIntraductal papillary mucinous neoplasms of the pancreas are being recognized with increasing frequency. MethodsAll patients who underwent pancreatic resection for an IPMN at the Johns Hopkins Hospital between January 1987 and December 2000 were studied. The data were compared with those of 702 concurrent patients with infiltrating ductal adenocarcinoma of the pancreas not associated with an IPMN resected by pancreaticoduodenectomy. ResultsIn the 13-year time period, 60 patients underwent pancreatic resection for IPMNs, with 40 patients undergoing resection in the past 3 years. Mean age at presentation was 67.4 Ϯ 1.4 years. The most common presenting symptom in patients with IPMNs was abdominal pain (59%). Most IPMNs were in the head of the pancreas or diffusely involved the gland, with 70% being resected via pancreaticoduodenectomy, 22% via total pancreatectomy, and 8% via distal pancreatectomy. Twenty-two patients (37%) had IPMNs with an associated infiltrating adenocarcinoma. In a subset of IPMNs immunohistochemically stained for the Dpc4 protein (n ϭ 50), all of the intraductal or noninvasive components strongly expressed Dpc4, whereas 84% of associated infiltrating cancers expressed Dpc4. The 5-year survival rate for all patients with IPMNs (n ϭ 60) was 57%. ConclusionIntraductal papillary mucinous neoplasms represent a distinct clinicopathologic entity being recognized with increasing frequency. IPMNs are clinically, histologically, and genetically disparate from pancreatic ductal adenocarcinomas. The distinct clinical features, the presumably long in situ or noninvasive phase, and the good long-term survival of patients with IPMNs offer a unique opportunity for early diagnosis, curative resection, and further studies of the molecular genetics and natural history of these unusual neoplasms.

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Section: Discussionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Intraductal Papillary Mucinous Neoplasms of the Pancreas: An Increasingly Recognized Clinicopathologic Entity

et al. 2001

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“…1). IPMN and similar lesions were previously referred to by a variety of names such as cystic adenocarcinoma [10], mucin-producing tumor [2], diffuse intraductal papillary adenocarcinoma [11], diffuse villous adenoma [12,13], mucinous pancreatic duct ectasia [14], intraductal cystadenocarcinoma [15], intraductal mucin-hypersecreting neoplasm [16], mucinous ductal ectasia [17], papillary adenoma [18], intraductal mucin-producing tumor [19,20], ductectatic type pancreatic ductal carcinoma [21], mucin-hypersecreting tumor [22], mucous-hypersecreting tumor [23], and intraductal papillary neoplasm [24]. Mucin-hypersecreting tumor was previously divided into the main duct type, the branch duct type, and the peripheral type according to the main location of the involvement.…”

Section: Definitions and Classificationmentioning

confidence: 99%

Thirty Years of Experience with Intraductal Papillary Mucinous Neoplasm of the Pancreas: From Discovery to International Consensus

Tanaka¹

2014

Digestion

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Background: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified as the main duct type (MD-IPMN) and the branch duct type (BD-IPMN) according to the location of involvement, and into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to the histomorphological and immunohistochemical characteristics. Mucin core protein expression correlates with the biological behavior and prognosis of the tumor. DNA analysis has shown that IPMN is associated with a number of gene mutations, but the roles of many of these mutations require further investigation. Most patients with MD-IPMN undergo tumor resection. Patients with BD-IPMN who do not undergo resection may develop malignant change, and concomitant separate pancreatic cancer occurs in 2-10% of patients with IPMN. Patients with a strong family history may develop multiple BD-IPMNs as well as concomitant pancreatic cancer. Malignant changes are relatively easy to detect, especially by endoscopic ultrasonography (EUS), but the optimal surveillance protocol is currently unclear. Key Messages: The 2012 guidelines for the management ofIPMN recommend that patients with ‘high-risk stigmata' (obstructive jaundice, enhanced solid component, and main pancreatic duct size ≥10 mm) should undergo resection. Patients with ‘worrisome features' (cyst size ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, main pancreatic duct size 5-9 mm, abrupt change in main pancreatic duct caliber with distal pancreatic atrophy, lymphadenopathy, and clinical acute pancreatitis) should be evaluated by EUS. EUS is a more sensitive test than computed tomography or magnetic resonance imaging for the early detection of malignancy. Conclusions: Most patients with MD-IPMN should undergo tumor resection. Patients with BD-IPMN who do not undergo resection should undergo careful surveillance including EUS for the early detection of malignant change and separate pancreatic cancer.

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“…Discussion Ductectaticmucinouscysticneoplasmsof the pancreas,also known asductectatic muci nous cystadenoma and cystadenocarcinoma [2] or mucinous ductal ectasia of the pancreas [3]. are characterized by the presence of a mass lesion that represents localized cystic dilatation of a branch duct of the pancreas.…”

Section: Table2 Summarizes Mrcp Findingscompared With Thoseof Ercpmentioning

confidence: 99%

Ductectatic mucinous cystic neoplasms of the pancreas: evaluation with MR cholangiopancreatography.

Onaya¹,

Itai²,

Niitsu³

et al. 1998

American Journal of Roentgenology

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T he pathologic and radiologic features of ductectatic mucinous cystadenoma and cystaclenocarci nomaof the pancreashavebeenclarified [1â€"5]. These tumors originate from ductal epithelial cells within the pancreaticduct branches.This entity is characterized by a cystic dilatation of a branchof the pancreaticduct that often contains thick mucin, frequently locatedin the uncinate process of the pancreas [2]. Macroscopically, the lesion is covered with thin pancreatic paren chyma and consists of a conglomeration of com

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Mucinous pancreatic duct ectasia in the body of the pancreas.

Cited by 70 publications

References 0 publications

Intraductal Papillary Mucinous Neoplasms of the Pancreas: An Increasingly Recognized Clinicopathologic Entity

Intraductal Papillary Mucinous Neoplasms of the Pancreas: An Increasingly Recognized Clinicopathologic Entity

Thirty Years of Experience with Intraductal Papillary Mucinous Neoplasm of the Pancreas: From Discovery to International Consensus

Ductectatic mucinous cystic neoplasms of the pancreas: evaluation with MR cholangiopancreatography.

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