Advertisement

Intraductal papillary-mucinous tumor and mucinous cystic neoplasm

CT and MR findings
  • Yuji ItaiEmail author
  • Manabu Minami
Review Article

Summary

Cystic lesions of the pancreas are increasingly detected by imaging at daily clinical practice. Among them mucinous cystic tumor and intradcutal papillary-mucinous tumor of the pancreas are clinically important since they are latently or overtly malignant and still have potentially good prognosis after resection. In this review article we describe history, clinicopathology and differential diagnosis of two entities, and findings and role of CT and MR imaging as well as MR cholangiopancreatography in the diagnosis and evaluation of intraductal papillary-mucinous tumor.

Key Words

Intraductal papillary-mucinous tumor mucinous cystic tumor CT MRI Magnetic Resonance Cholangiopancreatography (MRCP) 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Compagno J, Oertel JE. Mucinous cystic neoplasm of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma): a clinicopathologic study of 41 cases. Am J Clin Pathol 1978;69:573–580.PubMedGoogle Scholar
  2. 2.
    Hodgkinson DJ, ReMine WH, Weiland LH. Pancreatic cystadenoma: a clinicopathologic study of 45 cases. Arch Surg 1978;113:512–519.PubMedGoogle Scholar
  3. 3.
    Itai Y, Moss AA, Ohtomo K. Computed tomography of cystadenoma and cystadenoma of the pancreas. Radiology 1982;171:419–425.Google Scholar
  4. 4.
    Friedman AC, Lichtenstein JE, Dachman AH. Cystic neoplasms of the pancreas: radiologic-pathologic correlation. Radiology 1983;149:45–50.PubMedGoogle Scholar
  5. 5.
    George DH, Murphy F, Michalski R, Ulmer BG. Serous cystadenocarcinoma of the pancreas: a new entity? Am J Pathol 1989;13:61–66.CrossRefGoogle Scholar
  6. 6.
    Ohashi K, Murakami Y, Maruyama M, et al. Four cases with mucus producing pancreas carcinoma: specific findings of Papilla Vateri. Prog Digest Endosc. 1982;20:348–351 (in Japanese).Google Scholar
  7. 7.
    Takagi K, Ohashi K, Ohta T, et al. Pancreas carcinoma with a good prognosis. Ito Cho 1982;17:1065–1070 (abstr in English).Google Scholar
  8. 8.
    Itai Y, Araki T, Tasaka A, Maruyama M. Computed tomographic appearance of resectable pancreatic carcinoma. Radiology 1982;143:719–726.PubMedGoogle Scholar
  9. 9.
    Itai Y, Kokubo T, Atomi Y, et al. Mucin-hypersecreting carcinoma of the pancreas. Radiology 1987;165:51–55.PubMedGoogle Scholar
  10. 10.
    Kato Y, Yanagisawa A. Mucin-producing cancer of the pancreas: concept and classification. Tan to Sui 1986;7:731–738 (in Japanese).Google Scholar
  11. 11.
    Itai Y, Ohhashi K, Nagai H, et al. ‘Ductectatic’ mucinous cystadenoma and cystadenocarcinoma of the pancreas. Radiology 1986;161:697–700.PubMedGoogle Scholar
  12. 12.
    Kuroda A. Recent progress in clinicopathology of pancreatic tumors Tan to Sui 1988;9:1459–1472 (in Japanese.)Google Scholar
  13. 13.
    Nakazawa S, Yamao K, Yamada M, et al. Study of the classification of mucin-producing tumor of the pancreas. Jpn J Gastroent 1988;85:924–932 (abstr in English).Google Scholar
  14. 14.
    Khöppel H, Solcia E, Longnecker DS, et al. Histological typing of tumors of the exocrine pancreas. International Histological Classification of Tumors. 2nd ed. Berlin: Springer-Verlag, 1996.Google Scholar
  15. 15.
    Agostini S, Choux R, Payan MJ, et al. Mucinous pancreatic duct ectasia in the body of the pancreas. Radiology 1989;170:815–816.PubMedGoogle Scholar
  16. 16.
    Yamada M, Kozuka S, Yamao K, et al. Mucin-producing tumor of the pancreas. Cancer 1991;68:159–168.PubMedCrossRefGoogle Scholar
  17. 17.
    Rickaert F, Cremer M, Devière J, et al. Intraductal mucinhypersecreting neoplasm of the pancreas: a clinicopathologic study of eight patients. Gastroenterology 1991;101:512–519.PubMedGoogle Scholar
  18. 18.
    Conley CR, Scheithauer BW, van Hearden JA, Weiland LH. Diffuse intraductal papillary adenocarcinoma of the pancreas. Ann Surg 1987;205:246–249.PubMedCrossRefGoogle Scholar
  19. 19.
    Case records of Massachusetts General Hospital (Case 23-1994). N Engl J Med 1994;330:1671–1676.Google Scholar
  20. 20.
    Sessa F, Solcia E, Capella C, et al. Intraductal papillarymucinous tumors represent a distinct group of pancreatic neoplasms: an investigation of tumor cell differentiation and k-ras, p53 and c-erb B-2 abnormalities in 26 patients. Virchows Arch 1994;425:357–367.PubMedCrossRefGoogle Scholar
  21. 21.
    Loftus EV, Olivares-Pakzad BA, Batts KP, et al. Intraductal papillary-mucinous tumors of the pancreas: clinicopathologic features, outcome, and nonmenclature. Gastroenterology 1996;110:1909–1918.PubMedCrossRefGoogle Scholar
  22. 22.
    Nagai E, Ueki T, Chijiiwa K, et al. Intraductal papillary mucinous neoplasms of the pancreas associated with so-called ‘mucinous ductal ectasia’: histochemical and immunohistochemical analysis of 29 cases. Am J Surg Pathol 1995;19:576–579.PubMedCrossRefGoogle Scholar
  23. 23.
    Solcia E, Capella C, Klöppel G. Tumor of the Pancreas. Atlas of tumor phathology. 3rd series, Fascicle 20. Washington, DC, Armed Forces Institute of Pathology, 1997.Google Scholar
  24. 24.
    Klöppel G. Clinical pathology of exocrine pancreas. in Surgical Diseases of the Pancreas. 3rd ed. by Howard F, et al. Williams & Wilkins, Baltimore, MD, 1998, pp. 467–477.Google Scholar
  25. 25.
    Mathieu D, Guigui B, Valette PJ, et al. Pancreatic cystic neoplasms. Radiol Clin North Am 1989;27:163–176.PubMedGoogle Scholar
  26. 26.
    Johnson CD, Stephens BH, Charboneau JW, et al. Cystic pancreatic tumors CT and sonographic assessment. AJR 1988;151:1133–1138.PubMedGoogle Scholar
  27. 27.
    Itoh S, Ishiguchi T, Ishigaki T, et al. Mucin-producing pancreatic tumor: CT findings and histopathologic correlation. Radiology 1992;183:81–86.PubMedGoogle Scholar
  28. 28.
    Procacci C, Graziani R, Bicego E, et al. Intraductal mucinproducing tumor of the pancreas: imaging findings. Radiology 1996;198:249–257.PubMedGoogle Scholar
  29. 29.
    Itai Y, Ohtomo K. Cystic tumours of the pancreas. Eur Radiol 1996;6:844–850.PubMedCrossRefGoogle Scholar
  30. 30.
    Procacci C, Megibow AJ, Carbognin G, et al. Intraductal papillary mucinous tumor of the pancreas: a pictorial essay. Radio Graphics 1999;19:1444–1463.Google Scholar
  31. 31.
    Silas AM, Morrin MM, Raptopoulos V, Kogan MT. Intraductal papillary mucinos tumors of the pancreas. AJR 2001;176:179–185.PubMedGoogle Scholar
  32. 32.
    McDowell RK, Gazelle GS, Murphy BL, et al. Mucinous ductal ectasia of the pancreas. J Comput Assist Tomogr 1997;21:383–388.PubMedCrossRefGoogle Scholar
  33. 33.
    Sugawa C, Walt AJ. Endoscopic retrograde pancreatography in the surgery of pancreatic pseudocysts. Surgery 1979;86:639–647.PubMedGoogle Scholar
  34. 34.
    Koito K, Namieno T, Ichimura T, et al. Mucin-producing pancreatic tumors: comparison of MR cholangiopancreatography with endoscopic retrograde cholangiopancreatography. Radiology 1998;208:231–237.PubMedGoogle Scholar
  35. 35.
    Onaya H, Itai Y, Niitsu M, et al. Ductectatic mucinous cystic neoplasms of the pancreas: evaluation with MR cholangiopancreatography. AJR 1998;171:171–177.PubMedGoogle Scholar
  36. 36.
    Thompson LDR, Becker RC, Przygodzki RM, et al. Mucinous cystic neoplasm (mucinous cystic denocarcinoma of low-grade malignant potential) of the pancreas. Am J Surg Pathol 1999;23:1–16.PubMedCrossRefGoogle Scholar
  37. 37.
    Zamboni G, Scarpa A, Bogina G, et al. Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. Am J Surg Pathol 1999;23:410–422.PubMedCrossRefGoogle Scholar
  38. 38.
    Kuroda A. IPMT: classification, nonmenclature and differentiation from MCT. Tan to Sui 2000;21:523–526 (in Japanese).Google Scholar
  39. 39.
    Yamao K. Personal communication.Google Scholar
  40. 40.
    Procacci C, Biasiutti C, Carbognin G, et al. Characterization of cystic tumors of the pancreas: CT accuracy. J Comput Assist Tomogr 1999;23:906–912.PubMedCrossRefGoogle Scholar
  41. 41.
    Curry CA, Eng J, Horton KM, et al. CT of primary cystic pancreatic neoplasms: Can CT be used for patient triage and treatment? AJR 2000;175:99–103.PubMedGoogle Scholar
  42. 42.
    Itai Y, Ohhashi K, Furui S, et al. Microcystic adenoma of the pancreas: spectrum of computed tomography findings. J Comput Assist Tomogr 1988;12:797–803.PubMedCrossRefGoogle Scholar
  43. 43.
    Minami M, Itai Y, Ohtomo K, et al. Cystic neoplasm of the pancreas: comparison of MR imaging with CT. Radiology 1989;171:53–56.PubMedGoogle Scholar
  44. 44.
    Yamashita Y, Namimoto T, Mitsuzaki K, et al. Mucinproducing tumor of the pancreas: diagnostic value of diffusion-weighted echo-planar MR imaging. Radiology 1998;208:605–609.PubMedGoogle Scholar
  45. 45.
    Sugiyama M, Atomi Y. Intraductal papillary mucinous tumors of the pancreas: imaging studies and treatment strategies. Ann Surg 1998;228:685–691.PubMedCrossRefGoogle Scholar
  46. 46.
    Usuki N, Okabe Y, Miyamoto T. Intraductal mucinproducing tumor of the pancreas: diagnosis by MR cholangiopancreatography. J Comput Assist Tomogr 1998;22:875–879.PubMedCrossRefGoogle Scholar
  47. 47.
    Fukuhura Y, Fujiyoshi F, Sasaki M, et al. HASTE cholangiopancreatography in the evaluation of intraductal papillary-mucinous tumors of the pancreas. J Comput Assist Tomogr 1999;23:301–305.CrossRefGoogle Scholar
  48. 48.
    Irie H, Honda H, Aibe H, et al. MR cholangiopancreatographic differentiation of benign and malignat intraductal mucin-producing tumors of the pancreas. AJR 2000;174:1403–1408.PubMedGoogle Scholar
  49. 49.
    Arakawa A, Yamashita Y, Namimoto T, et al. Intraductal papillary tumors of the pancreas: histopathologic correlation of MR cholangiopancreatography findings. Acta Radiol 2000;41:343–347.PubMedCrossRefGoogle Scholar
  50. 50.
    Maguchi H. Clinicopathological and diagnostic study of mucin producing pancreatic tumors. Jpn J Gastroent 1994;91:1003–1015 (abstr in English).Google Scholar
  51. 51.
    Maguchi H, Takahashi K, Itoh H, et al. Therapeutic strategy for mucin-producing tumor of the pancreas: surgery or follow up. J Gastroent Imaging 2001;3:329–336 (in Japanese).Google Scholar
  52. 52.
    Yamanaka K. Selection of treatment for intraductal papillary mucinous tumor of the pancreas. J Jpn Panc Soc 2001;16:455–459 (abstr in English).Google Scholar
  53. 53.
    Ariyama J, Suyama M, Satoh K, Wakabayashi K. Endoscopic ultrasound and intraductal ultrasound in the diagnosis of small pancreatic tumors. Abdom Imaging 1998;23:380–386.PubMedCrossRefGoogle Scholar
  54. 54.
    Inui K, Nakazawa S, Yoshino J, et al. Mucin-producing tumor of the pancreas: intraluminal ultrasonography. Hepato-Gastroenterology 1998;45:1996–2000.PubMedGoogle Scholar
  55. 55.
    Yamao K, Ohashi K, Nakamura T, et al. The prognosis of intraductal papillary mucinous tumor of the pancreas. Hepato-Gastroenterology 2000;47:1129–1134.PubMedGoogle Scholar
  56. 56.
    Itai Y, Moss AA, Goldberg HI. Pancreatic cysts caused by carcinoma of the pancreas: a pitfall in the diagnosis of pancreatic carcinoma. J Comput Assist Tomogr 1982;6:772–776.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc 2001

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of TokyoTokyoJapan
  2. 2.Department of RadiologyUniversity of TsukubaTsukubaJapan

Personalised recommendations