Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiologic-pathologic correlation

Gopinathan, Anil; Zhang, Junwei; Hamar, Nawal Ebrahim Al; Nga, Min En

doi:10.5152/dir.2016.16104

Cited by 34 publications

(43 citation statements)

References 15 publications

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“…[82][83][84] Solid pseudopapillary neoplasm appears on computed tomography scan as a poorly enhancing, encapsulated, well-circumscribed, and heterogeneous mass with central necrosis. 85,86 EUS-guided FNA can aid in the diagnosis of SPNs and can differentiate SPNs from other radiologically similar neoplasms such as pancreatic neuroendocrine tumors (PanNETs) and acinar cell carcinoma (ACC). EUS-guided FNA of SPNs demonstrates a hypercellular smear consisting of delicate papillary fragments with fibrovascular stalks and perivascular myxoid matrix, lined by monomorphic cuboidal cells and arranged in cohesive groups and isolated cells ( Figure 11, A and B).…”

Section: Nonmucinous Cystic Neoplastic Lesionsmentioning

confidence: 99%

Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation

Abdelkader

Hunt

Hartley

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Pancreatic cystic lesions (PCLs) are very common, and their detection is increasing with the advances in imaging techniques. Because of the major implications for management, distinguishing between neoplastic and nonneoplastic PCLs is critical. Neoplastic cysts with potential to progress into cancer include mucinous PCLs (intraductal papillary mucinous neoplasms and mucinous cystic neoplasms) and nonmucinous cysts (solid pseudopapillary tumors, serous cystic neoplasms, and neuroendocrine tumors with cystic degeneration). Nonneoplastic cysts with no risk of malignant transformation include pseudocysts, retention cysts, lymphoepithelial cysts, cystic pancreatic lymphangioma, and duplication cyst/ciliated foregut cysts. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology with cyst fluid analysis in the diagnosis of PCLs has evolved during the last decade; however, a definitive diagnosis on cytologic specimens is hampered by the sparse cellularity and can be challenging. EUS-FNA can play an important role to differentiate low-risk from high-risk pancreatic cysts and to distinguish between patients with cysts who need clinical follow-up versus those who require surgery. Objective.— To provide an integrative approach to diagnose pancreatic cystic lesions using EUS-FNA cytology and cyst fluid analysis, along with clinical, radiologic, histologic, genetic, and molecular characteristics. Data Sources.— The review and analysis of the latest literature describing pancreatic cystic lesions. Conclusions.— Accurate diagnosis of PCLs requires a multidisciplinary and multimodal team approach, including the integration of clinical findings, imaging, cytology, cyst fluid analysis, and molecular testing.

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Section: Nonmucinous Cystic Neoplastic Lesionsmentioning

confidence: 99%

Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation

Abdelkader

Hunt

Hartley

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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“…CTNNB1 somatic mutation on exon 3 is the only known mutation in SPN to date. Like most tumours, when they are small, they are detected incidentally in imaging (USG, MRI, CT) [13][14][15][16][17][18]. Large tumours cause abdominal pain, abdominal discomfort, low-grade fever weight loss, and anaemia, and haemorrhage to the tumour may present a symptom of acute abdomen.…”

Section: Discussionmentioning

confidence: 99%

Solid pseudopapillary neoplasm of the pancreas: a case report

Ostańska

Aebisher

Bartusik‐Aebisher

2020

Medical Research Journal

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This paper presents a case report of a solid pseudopapillary neoplasm (SPN) of the pancreas, a discussion on the clinical-pathological, histopathological, and immunohistochemical picture, and a review of the literature regarding the occurrence of this type of cancer. The case of a 61-year-old woman with the presence of a lithium-cystic lesion of the body and tail of the pancreas was initially assessed by MRI as a pathological mass with the presence of abscesses. Double biopsy under EUS control was non-diagnostic. The patient underwent surgery to remove the body and tail of the pancreas together with the tumour and spleen. Tumour size 15×10×8 cm lithium-cystic, grey-brown, with the presence of numerous calcifications and bone metaplasia, and stones in the pancreatic duct. In the histopathological picture, solid woven with the presence of pseudodimplants and pseudocystic areas with haemorrhages. Positive tests for NSE, vimentin, PR, CD56, and cyclin D1 were obtained in immunohistochemical (IHC) tests. The patient was discharged from the hospital in good general condition and is under gastroenterological control. SPN is a rare cancer with low malignancy. The tumour most often occurs in teenagers or young women. Initially, it runs without ailments, until it is large. Then there is pain, nausea, and fever. The histopathological and cytological picture is suggestive, but it should be supported by research. SPN should be differentiated with neuroendocrine tumours (NENs) and acinar cancer and pancreatoblasoma. SPN generally has a good prognosis. Local relapses and distant metastases are rare.

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“…Classical imaging features of large SPNs consist of a well-circumscribed heterogeneous lesion with a thick (sometimes discontinuous) pseudocapsule (representing fibrosis and compressed pancreatic tissue), typically depicted as low density and low signal intensity (on both T1- and T2-weighted images) on CT and MRI, respectively [45,46,47]. Another characteristic imaging hallmark of SPNs is the combination of a central area of internal hemorrhage and cystic degeneration, and peripheral rim of solid components (fig.…”

Section: Common Pancreatic Cystic Neoplasmsmentioning

confidence: 99%

“…Another characteristic imaging hallmark of SPNs is the combination of a central area of internal hemorrhage and cystic degeneration, and peripheral rim of solid components (fig. 10) [45,46,47]. Peripheral calcification is present in up to 60% of cases, and central dystrophic calcifications may occur in areas of hemorrhage [40,48].…”

Section: Common Pancreatic Cystic Neoplasmsmentioning

confidence: 99%

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Radiological Workup of Cystic Neoplasms of the Pancreas

Bollen

Wessels

2018

Visc Med

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Pancreatic cystic lesions are being detected with increasing frequency because of increased use and improved quality of cross-sectional imaging techniques. Pancreatic cystic lesions encompass non-neoplastic lesions (such as pancreatitis-related collections) and neoplastic tumors. Common cystic pancreatic neoplasms include serous cystadenomas, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and solid pseudopapillary tumors. These cystic pancreatic neoplasms may have typical morphology, but at times show overlapping imaging features on cross-sectional examinations. This article reviews the classical and atypical imaging features of commonly encountered cystic pancreatic neoplasms and presents the limitations of current cross-sectional imaging techniques in accurately classifying pancreatic cystic lesions.

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Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiologic-pathologic correlation

Cited by 34 publications

References 15 publications

Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation

Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation

Solid pseudopapillary neoplasm of the pancreas: a case report

Radiological Workup of Cystic Neoplasms of the Pancreas

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