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Intraductal papillary mucinous neoplasm.

Publication ,  Journal Article
Shi, C; Hruban, RH
Published in: Hum Pathol
January 2012

Intraductal papillary mucinous neoplasm (IPMN) is a grossly visible (≥1 cm), mucin-producing neoplasm that arises in the main pancreatic duct and/or its branches. Patients with intraductal papillary mucinous neoplasm can present with symptoms caused by obstruction of the pancreatic duct system, or they can be asymptomatic. There are 3 clinical subtypes of intraductal papillary mucinous neoplasm: main duct, branch duct, and mixed. Five histologic types of intraductal papillary mucinous neoplasm are recognized: gastric foveolar type, intestinal type, pancreatobiliary type, intraductal oncocytic papillary neoplasm, and intraductal tubulopapillary neoplasm. Noninvasive intraductal papillary mucinous neoplasms are classified into 3 grades based on the degree of cytoarchitectural atypia: low-, intermediate-, and high-grade dysplasia. The most important prognosticator, however, is the presence or absence of an associated invasive carcinoma. Some main duct-intraductal papillary mucinous neoplasms progress into invasive carcinoma, mainly tubular adenocarcinoma (conventional pancreatic ductal adenocarcinoma) and colloid carcinoma. Branch duct-intraductal papillary mucinous neoplasms have a low risk for malignant transformation. Preoperative prediction of the malignant potential of an intraductal papillary mucinous neoplasm is of growing importance because pancreatic surgery has its complications, and many small intraductal papillary mucinous neoplasms, especially branch duct-intraductal papillary mucinous neoplasms, have an extremely low risk of progressing to an invasive cancer. Although most clinical decision making relies on imaging, a better understanding of the molecular genetics of intraductal papillary mucinous neoplasm could help identify molecular markers of high-risk lesions. When surgery is performed, intraoperative frozen section assessment of the pancreatic resection margin can guide the extent of resection. Intraductal papillary mucinous neoplasms are often multifocal, and surgically resected patients should be followed for metachronous disease.

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Published In

Hum Pathol

DOI

EISSN

1532-8392

Publication Date

January 2012

Volume

43

Issue

1

Start / End Page

1 / 16

Location

United States

Related Subject Headings

  • Pathology
  • Pancreatic Neoplasms
  • Pancreatic Ducts
  • Neoplasm Invasiveness
  • Mutation
  • Middle Aged
  • Humans
  • Frozen Sections
  • Carcinoma, Pancreatic Ductal
  • Aged
 

Citation

APA
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ICMJE
MLA
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Shi, C., & Hruban, R. H. (2012). Intraductal papillary mucinous neoplasm. Hum Pathol, 43(1), 1–16. https://doi.org/10.1016/j.humpath.2011.04.003
Shi, Chanjuan, and Ralph H. Hruban. “Intraductal papillary mucinous neoplasm.Hum Pathol 43, no. 1 (January 2012): 1–16. https://doi.org/10.1016/j.humpath.2011.04.003.
Shi C, Hruban RH. Intraductal papillary mucinous neoplasm. Hum Pathol. 2012 Jan;43(1):1–16.
Shi, Chanjuan, and Ralph H. Hruban. “Intraductal papillary mucinous neoplasm.Hum Pathol, vol. 43, no. 1, Jan. 2012, pp. 1–16. Pubmed, doi:10.1016/j.humpath.2011.04.003.
Shi C, Hruban RH. Intraductal papillary mucinous neoplasm. Hum Pathol. 2012 Jan;43(1):1–16.
Journal cover image

Published In

Hum Pathol

DOI

EISSN

1532-8392

Publication Date

January 2012

Volume

43

Issue

1

Start / End Page

1 / 16

Location

United States

Related Subject Headings

  • Pathology
  • Pancreatic Neoplasms
  • Pancreatic Ducts
  • Neoplasm Invasiveness
  • Mutation
  • Middle Aged
  • Humans
  • Frozen Sections
  • Carcinoma, Pancreatic Ductal
  • Aged