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Pathologie und Klassifikation intraduktaler papillär muzinöser Neoplasien des Pankreas

Pathology and classification of intraductal papillary mucinous neoplasms of the pancreas

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Zusammenfassung

Intraduktale papillär muzinöse Neoplasien (IPMN) sind Vorläuferläsionen des duktalen Pankreaskarzinoms und gehören zu den häufigsten zystischen Raumforderungen im Pankreas. Nach dem Ausgangspunkt der Läsion werden der Hauptgangtyp und der Seitengangtyp unterschieden. Zusätzlich erfolgt nach dem histologischen Bild und dem immunhistochemischen Profil die Einteilung in 4 Subtypen (intestinal, gastrisch, pankreatobiliär und onkozytär), die mit signifikant unterschiedlicher Prognose einhergehen. Der vorliegende Beitrag bietet eine Übersicht über das unterschiedliche Malignitätsrisiko der Subtypen, die Prognose der assoziierten invasiven Karzinome und gibt Empfehlungen zur pathologischen Begutachtung der IPMN.

Abstract

Intraductal papillary mucinous neoplasms (IPMN) are precursor lesions of ductal adenocarcinoma of the pancreas and one of the most common cystic entities in this organ. Branch and main duct types are further distinguished based on the tumor localization. An additional classification is based on the predominant architecture and immunohistochemical profile with four prognostic relevant subtypes, gastric, intestinal, pancreato-biliary and oncocytic. This review provides an overview about the malignant potential of the different subtypes and the prognosis of associated invasive tumors and gives recommendations for the pathological assessment of resection specimens with IPMNs.

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  1. Institut für Pathologie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    A.M. Schlitter &  I. Esposito

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  1. A.M. Schlitter
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  2. I. Esposito
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Correspondence to I. Esposito.

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Schlitter, A., Esposito, I. Pathologie und Klassifikation intraduktaler papillär muzinöser Neoplasien des Pankreas. Chirurg 83, 110–115 (2012). https://doi.org/10.1007/s00104-011-2181-x

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