Abstract
Intraductal papillary neoplasms include intraductal papillary mucinous neoplasm (IPMN) and intraductal tubulopapillary neoplasm (ITPN). These are both discussed in this chapter, together with a brief mention of other (non-ductal) neoplasms that can show intraductal growth in the pancreas. The classification, sampling, morphological features, and different mucin profiles of IPMNs are included, together with discussion of the lengthy differential diagnosis. Up-to-date guidance on management and a reporting checklist are also provided.
Keywords
Invasive Carcinoma Main Pancreatic Duct Intraductal Papillary Mucinous Neoplasm Branch Duct Oncocytic Carcinoma
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
- 1.Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumors of the digestive system. Lyon: IARC; 2010. p. 280. chapter 12.Google Scholar
- 2.Hruban RH, Takaori K, Klimstra DS, Adsay NV, Albores-Saavedra J, Biankin AV, et al. An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2004;28:977–87.PubMedCrossRefGoogle Scholar
- 3.Rebours V, Couvelard A, Peyroux JL, Sauvanet A, Hammel P, Ruszniewski P, et al. Familial intraductal papillary mucinous neoplasms of the pancreas. Dig Liver Dis. 2012;44:442–6.PubMedCrossRefGoogle Scholar
- 4.Tanaka M, Fernández-Del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183–97.PubMedGoogle Scholar
- 5.Waters JA, Schmidt CM, Pinchot JW, White PB, Cummings OW, Pitt HA, et al. CT vs MRCP: optimal classification of IPMN type and extent. J Gastrointest Surg. 2008;12:101–9.PubMedCrossRefGoogle Scholar
- 6.Correa-Gallego C, Ferrone CR, Thayer SP, Wargo JA, Warshaw AL, Fernández-Del Castillo C. Incidental pancreatic cysts: do we really know what we are watching? Pancreatology. 2010;10:144–50.PubMedCrossRefGoogle Scholar
- 7.Tanaka M. Controversies in the management of pancreatic IPMN. Nat Rev Gastroenterol Hepatol. 2011;8:56–60.PubMedCrossRefGoogle Scholar
- 8.Mino-Kenudson M, Fernández-del Castillo C, Baba Y, Valsangkar NP, Liss AS, Hsu M, et al. Prognosis of invasive intraductal papillary mucinous neoplasm depends on histological and precursor epithelial subtypes. Gut. 2011;60:1712–20.PubMedCrossRefGoogle Scholar
- 9.Zapiach M, Yadav D, Smyrk TC, Fletcher JG, Pearson RK, Clain JE, et al. Calcifying obstructive pancreatitis: a study of intraductal papillary mucinous neoplasm associated with pancreatic calcification. Clin Gastroenterol Hepatol. 2004;2:57–63.PubMedCrossRefGoogle Scholar
- 10.Del Chiaro M, Verbeke C, Salvia R, Klöppel G, Werner J, McKay C, Friess H, Manfredi R, van Cutsem E, Löhr M, Segersvard R and the European Study Group on Cystic Tumours of the Pancreas. European experts consensus statement on cystic tumours of the pancreas. Dig Liv Dis. 2013 [Epub ahead of print].Google Scholar
- 11.Longnecker DS, Adsay NV, Fernandez-del Castillo C, Hruban RH, Kasugai T, Klimstra DS, et al. Histopathological diagnosis of pancreatic intraepithelial neoplasia and intraductal papillary-mucinous neoplasms: interobserver agreement. Pancreas. 2005;31:344–9.PubMedCrossRefGoogle Scholar
- 12.Katabi N, Klimstra DS. Intraductal papillary mucinous neoplasms of the pancreas: clinical and pathological features and diagnostic approach. J Clin Pathol. 2008;61:1303–13.PubMedCrossRefGoogle Scholar
- 13.Yamaguchi K, Kanemitsu S, Hatori T, Maguchi H, Shimizu Y, Tada M, et al. Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN. Pancreas. 2011;40:571–80.PubMedCrossRefGoogle Scholar
- 14.Kelly PJ, Shinagare S, Sainani N, Hong X, Ferrone C, Yilmaz O, et al. Cystic papillary pattern in pancreatic ductal adenocarcinoma: a heretofore undescribed morphologic pattern that mimics intraductal papillary mucinous carcinoma. Am J Surg Pathol. 2012;36:696–701.PubMedCrossRefGoogle Scholar
- 15.Katabi N, Torres J, Klimstra DS. Intraductal tubular neoplasms of bile ducts. Am J Surg Pathol. 2012;36:1647–55.PubMedCrossRefGoogle Scholar
- 16.Yamaguchi H, Shimizu M, Ban S, Koyama I, Hatori T, Fujita I, et al. Intraductal tubulopapillary neoplasms of the pancreas distinct from pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2009;33:1164–72.PubMedCrossRefGoogle Scholar
- 17.Furukawa T, Hatori T, Fujita I, Yamamoto M, Kobayashi M, Ohike N, et al. Prognostic relevance of morphological types of intraductal papillary mucinous neoplasms of the pancreas. Gut. 2011;60:509–16.PubMedCrossRefGoogle Scholar
- 18.Nakata K, Ohuchida K, Aishima S, Sadakari Y, Kayashima T, Miyasaka Y, et al. Invasive carcinoma derived from intestinal-type intraductal papillary mucinous neoplasm is associated with minimal invasion, colloid carcinoma, and less invasive behavior, leading to a better prognosis. Pancreas. 2011;40:581–7.PubMedCrossRefGoogle Scholar
- 19.Yopp AC, Katabi N, Janakos M, Klimstra DS, D’Angelica MI, DeMatteo RP, et al. Invasive carcinoma arising in intraductal papillary mucinous neoplasms of the pancreas: a matched control study with conventional pancreatic ductal adenocarcinoma. Ann Surg. 2011;253:968–74.PubMedCrossRefGoogle Scholar
- 20.Nara S, Shimada K, Kosuge T, Kanai Y, Hiraoka N. Minimally invasive intraductal papillary-mucinous carcinoma of the pancreas: clinicopathologic study of 104 intraductal papillary-mucinous neoplasms. Am J Surg Pathol. 2008;32:243–55.PubMedCrossRefGoogle Scholar
Further Reading
- Adsay NV, Fukushima N, Furukawa T, Hruban RH, Klimstra DS, Klöppel G, et al. Intraductal neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumours of the digestive system, World Health Organization Classification of tumours. Lyon: IARC; 2010. p. 304–13. Chapter 12.Google Scholar
- Hruban RH, Pitman MB, Klimstra DS. Tumors of the pancreas, Atlas of tumor pathology, 4th series, fascicle 6. Washington, DC: Armed Forces Institute of Pathology; 2007. p. 75–110, chapter 6.Google Scholar
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© Springer-Verlag London 2013