Pancreatic Cysts: Depiction on Single-Shot Fast Spin-Echo MR Images

Zhang, Xiaoming; Mitchell, Donald G.; Dohke, Masako; Holland, George A.; Parker, Laurence

doi:10.1148/radiol.2232010815

Cited by 370 publications

(193 citation statements)

References 19 publications

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“…Management of these cysts is concomitantly becoming a major clinical problem (1,2). Cystic lesions occur in more than 20% of patients examined at autopsy (3), in as many as 19.6% of patients evaluated by MRI (4)(5)(6), and in as many as 2.6% of patients evaluated by computed tomography (7,8). In the vast majority of cases, the cysts are identified as incidental findings in patients undergoing imaging for symptoms unrelated to pancreatic pathology.…”

mentioning

confidence: 99%

Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways

Jiao

Molin³

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

581

552

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More than 2% of adults harbor a pancreatic cyst, a subset of which progresses to invasive lesions with lethal consequences. To assess the genomic landscapes of neoplastic cysts of the pancreas, we determined the exomic sequences of DNA from the neoplastic epithelium of eight surgically resected cysts of each of the major neoplastic cyst types: serous cystadenomas (SCAs), intraductal papillary mucinous neoplasms (IPMNs), mucinous cystic neoplasms (MCNs), and solid pseudopapillary neoplasms (SPNs). SPNs are low-grade malignancies, and IPMNs and MCNs, but not SCAs, have the capacity to progress to cancer. We found that SCAs, IPMNs, MCNs, and SPNs contained 10 ± 4.6, 27 ± 12, 16 ± 7.6, and 2.9 ± 2.1 somatic mutations per tumor, respectively. Among the mutations identified, E3 ubiquitin ligase components were of particular note. Four of the eight SCAs contained mutations of the von Hippel-Lindau gene (VHL), a key component of the VHL ubiquitin ligase complex that has previously been associated with renal cell carcinomas, SCAs, and other neoplasms. Six of the eight IPMNs and three of the eight MCNs harbored mutations of RNF43, a gene coding for a protein with intrinsic E3 ubiquitin ligase activity that has not previously been found to be genetically altered in any human cancer. The preponderance of inactivating mutations in RNF43 unequivocally establish it as a suppressor of both IPMNs and MCNs. SPNs contained remarkably few genetic alterations but always contained mutations of CTNNB1, previously demonstrated to inhibit degradation of the encoded protein (β-catenin) by E3 ubiquitin ligases. These results highlight the essential role of ubiquitin ligases in these neoplasms and have important implications for the diagnosis and treatment of patients with cystic tumors.

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mentioning

confidence: 99%

Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways

Jiao

Molin³

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

581

552

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“…This has been reported in up to 25% of patients, particularly with increasing age [1,2] . From a pathological rather than imaging perspective, however, a cyst is formally defined as a fluid-filled and closed cavity with an epithelial lining.…”

Section: Introductionmentioning

confidence: 94%

Intraductal papillary mucinous neoplasms and other pancreatic cystic lesions

Freeman¹

2008

WJG

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Pancreatic cystic neoplasms are being increasingly recognized, even in the absence of symptoms, in large part, due to markedly improved imaging modalities such as magnetic resonance imaging (MRI)/magnetic resonance cholangio pancreatography (MRCP) and computer tomography (CT) scanning. During the past 2 decades, better imaging of these cystic lesions has resulted in definition of different types, including pancreatic intraductal papillary mucinous neoplasms ( I P M N ) . W h i l e I P M N r e p r e s e n t o n l y a d i s t i n c t minority of all pancreatic cancers, they appear to be a relatively frequent neoplastic form of pancreatic cystic neoplasm. Moreover, IPMN have a much better outcome and prognosis compared to pancreatic ductal adenocarcinomas. Therefore, recognition of this entity is exceedingly important for the clinician involved in diagnosis and further evaluation of a potentially curable form of pancreatic cancer.

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“…The prevalence of pancreatic cysts in the United States has been estimated in patients undergoing MRI for a number of various medical problems [3]. This review of MRI images revealed about 15 ± 20 % of 1,444 patients had at least one pancreatic cyst.…”

Section: Prevalencementioning

confidence: 99%

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

Brugge

2006

Endoscopy

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IntroductionCystic lesions of the pancreas consist of a spectrum of benign, pre-malignant, and malignant malignancies. In the past, cystic neoplasms of the pancreas were thought to be relatively rare, but the widespread use of cross sectional imaging has dramatically increased ability to detect these lesions. Although the vast majority of pancreatic cysts are discovered incidentally, large or invasive lesions may produce sufficient symptoms to cause the patient to seek medical attention.Cystic neoplasms are often confused or misdiagnosed as pseudocysts or peripancreatic collections of inflammatory fluid that may morphologically mimic cystic neoplasms. Furthermore, the presenting symptoms of pseudocysts may be identical to the symptoms associated with cystic neoplasms.Cystic neoplasms of the pancreas are traditionally organized by the type of lining epithelium since this feature dominates the risk of malignancy and management [1] ( Table 1). There are three types of mucinous lesions, benign mucinous cystadenomas, malignant mucinous cystic lesions, and intra-ductal papillary mucinous neoplasms (IPMNs). The non-mucinous lesions include serous cystadenomas, cystic endocrine tumors and other rare lesions. PrevalenceThe prevalence of pancreatic cysts has been examined with autopsy examinations of the pancreas in adults without known pancreatic disease. The prevalence of pancreatic cysts found at autopsies in Japan was approximately 73 of 300 autopsies (24.3 %) cases [2]. The prevalence of cysts increased with increasing age of the patient. The cysts were located throughout the pancreatic parenchyma and were not related to chronic pancreatitis. The epithelium of the cysts displayed a spectrum of neoplastic change, including atypical hyperplasia (16.4 %); carcinoma in situ (3.4 %).

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Pancreatic Cysts: Depiction on Single-Shot Fast Spin-Echo MR Images

Cited by 370 publications

References 19 publications

Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways

Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways

Intraductal papillary mucinous neoplasms and other pancreatic cystic lesions

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

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