Imaging and Cytopathological Criteria Indicating Malignancy in Mucin-Producing Pancreatic Neoplasms: A Series of 68 Histopathologically Confirmed Cases
| Autor: | Maria Tsopanomichalou, Ioannis Karoumpalis, Stamatios Theocharis, Aristidis Ikonomakis, Panagiotis Konstantinou, Charitini Salla, Eleni Karvouni, Athanasia Sepsa, Despoina Georgiadou, Ekaterini Politi, Akrivi Kostopoulou, Gregory G. Tsiotos, Kleio Papaparaskeva, Ilias P. Nikas, Theodoros N. Sergentanis |
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| Rok vydání: | 2018 |
| Předmět: |
Endoscopic ultrasound
Male medicine.medical_specialty Pathology endocrine system diseases Endocrinology Diabetes and Metabolism Malignancy 03 medical and health sciences 0302 clinical medicine Endocrinology Cytology Internal Medicine medicine Carcinoma Humans Cyst Endoscopic Ultrasound-Guided Fine Needle Aspiration Pancreas Aged Pancreatic duct Hepatology medicine.diagnostic_test business.industry Middle Aged medicine.disease Adenocarcinoma Mucinous Carcinoma Papillary Pancreatic Neoplasms medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Histopathology Female business Neoplasms Cystic Mucinous and Serous Carcinoma Pancreatic Ductal |
| Zdroj: | Pancreas. 47(10) |
| ISSN: | 1536-4828 |
| Popis: | OBJECTIVES This study aims to evaluate the performance of clinical, imaging, and cytopathological criteria in the identification of high-grade dysplasia/carcinoma (HGD/Ca) in pancreatic mucin-producing cystic neoplasms. METHODS Sixty-eight consecutive, histopathologically confirmed mucin-producing cystic neoplasms, evaluated by endoscopic ultrasound-guided fine-needle aspiration, were enrolled; specifically, 39 branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), 21 main duct IPMNs, and 8 mucinous cystic neoplasms. The associations between HGD/Ca in histopathology and findings of endoscopic ultrasound and cytology, demographic, lifestyle, and clinical parameters were evaluated, separately in IPMNs and mucinous cystic neoplasms. RESULTS Age 65 years or more was associated with HGD/Ca in IPMNs. In BD-IPMNs, cyst diameter 3 cm or greater (sensitivity, 68.8%; specificity, 65.2%), a mural nodule (sensitivity, 56.3%; specificity, 78.3%), main pancreatic duct diameter 5 to 9 mm (sensitivity, 50.0%; specificity, 87.0%), and suspicious cytology (sensitivity, 81.3%; specificity, 100%) signaled the presence of HGD/Ca. Similarly, in main duct IPMNs, suspicious cytology predicted HGD/Ca with high sensitivity (88.9%) and excellent specificity (100%). Regarding cytopathological criteria, in BD-IPMNs, HGD/Ca was associated with a high nuclear/cytoplasmic ratio, background necrosis, presence of papillary structures, hypochromatic nuclei, hyperchromatic nuclei, and major nuclear membrane irregularities (thickening and/or indentations). CONCLUSIONS Clinical, imaging, and cytopathological criteria are useful in the identification of HGD/Ca in IPMNs. |
| Databáze: | OpenAIRE |
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