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川本 裕介
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Non peer reviewed |
| Title | Pancreatic duct epithelial malignancy suggested by large focal pancreatic parenchymal atrophy in cystic diseases of the pancreas. |
| Journal | Formal name：Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Abbreviation：Pancreatology ISSN code：14243911/14243903 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 23(4),pp.420-428 |
| Author and coauthor | KIKUYAMA Masataka,NAKAHODO Jun,HONDA Goro,SUZUKI Mizuka,HORIGUCHI Shin-Ichiro,CHIBA Kazuro,TABATA Hiroki,OME Yusuke,UEMURA Shu-Ichiro,KAWAMOTO Yusuke,KAMISAWA Terumi |
| Publication date | 2023/06 |
| Summary | BACKGROUND:/Objectives: A cystic lesion is common in the pancreas. Focal pancreatic parenchymal atrophy (FPPA) has been reported as a sign of high-grade pancreatic intraepithelial neoplasia/carcinoma in situ (HGP/CIS). Some cystic lesions accompany FPPA. However, the relationship between a cystic lesion, FPPA, and the histopathological background of the pancreatic duct is unknown.METHODS:We retrospectively evaluated the data of 98 patients with a cystic lesion who underwent serial pancreatic juice aspiration cytologic examination (SPACE) because of accompanying FPPA, increased size of the cystic lesion, and pancreatic duct stricture at the base.RESULTS:The clinical diagnosis of a cystic lesion was intraductal papillary mucinous neoplasia (IPMN) and cysts in 72 (73.5%) and 26 (26.5%) patients, respectively. Ninety of the 98 patients (91.8%) had FPPA. Positive results (adenocarcinoma and suspicion) on SPACE were observed in 56 of all cases (57.1%), 48 of IPMN (66.7%), 8 of cysts (30.8%), and 54 of FPPA (59.3%), and were significantly associated with IPMN (p = 0.002) and the large FPPA (>269.79 mm2,p = 0.0001); moreover, these disorders are considerably related (p = 0.0003). Fifty patients (51.0%) with positive results on SPACE underwent surgery, with the histopathological diagnosis of epithelial malignancy in 42 patients (42.9%, 42/50, 84%). Many cystic lesions clinically diagnosed as IPMN were dilated branches covered by pancreatic intraepithelial neoplasia.CONCLUSIONS:Positive results on SPACE were significantly associated with the clinical diagnosis of IPMN and the large FPPA. Moreover, these disorders are significantly related. Surgery owing to positive results could lead to the histopathological diagnosis of HGP/CIS. |
| DOI | 10.1016/j.pan.2023.03.002 |
| PMID | 37003856 |