Difference between revisions of "Intraductal papillary mucinous tumour"
Jump to navigation
Jump to search
(split out) |
(→General: added a sentence about oncocytic type) |
||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
'''Intraductal papillary mucinous tumour''', abbreviated '''IPMT''', is an uncommon tumour of the [[pancreas]]. | '''Intraductal papillary mucinous tumour''', abbreviated '''IPMT''', is an uncommon tumour of the [[pancreas]]. | ||
It is also known as '''intraductal papillary mucinous neoplasm''' (abbreviated '''IPMN'''). | |||
==General== | ==General== | ||
| Line 8: | Line 10: | ||
***Main duct (bad prognosis). | ***Main duct (bad prognosis). | ||
***Branch (good prognosis). | ***Branch (good prognosis). | ||
Clinical: | Clinical: | ||
| Line 28: | Line 31: | ||
#*Less commonly associated with invasive carcinoma. | #*Less commonly associated with invasive carcinoma. | ||
The oncocytic subtype of IPMT is now known to be genetically separate from other types.<ref name=pmid27282351>{{cite journal |author=Basturk O, Tan M, Bhanot U, Allen P, Adsay V, Scott SN, Shah R, Berger MF, Askan G, Dikoglu E, Jobanputra V, Wrzeszczynski KO, Sigel C, Iacobuzio-Donahue C, Klimstra DS. |title=The oncocytic subtype is genetically distinct from other pancreatic intraductal papillary mucinous neoplasm subtypes |journal=Mod Pathol |volume=29 |pages=1058-69 |year=2016 |pmid=27282351 }}</ref> | |||
=====Behaviour===== | =====Behaviour===== | ||
*Adenoma. | *Adenoma. | ||
Latest revision as of 17:39, 10 February 2017
Intraductal papillary mucinous tumour, abbreviated IPMT, is an uncommon tumour of the pancreas.
It is also known as intraductal papillary mucinous neoplasm (abbreviated IPMN).
General
- Morphologically and biologically distinct from ductal adenocarcinoma, mucinous cystic tumour and ductal papillary hyperplasia.
- Prognosis:
Clinical:
- Patient usually not jaundiced... as no obstruction.
- Often diabetes... as pancreas is destroyed.
- Patients may get a total pancreatectomy - as the disease is often multifocal.
Epidemiology
- ~1% of all exocrine pancreatic tumours.
- More common in males.
- Mean age at presentation 62 years.
- 60-80% occur in the head of the pancreas.
- Average size 4 cm.
Classification of IMPT
Commonly classified by the duct involvement:[3]
- Main duct type.
- Commonly associated with invasive carcinoma.
- Branch duct type.
- Less commonly associated with invasive carcinoma.
The oncocytic subtype of IPMT is now known to be genetically separate from other types.[4]
Behaviour
- Adenoma.
- Borderline mucinous tumour.
- Carcinoma.
Notes:
- Borderline tumours are rare.
- If intralobular dilated ducts... carcinoma.
- Any margin with mucin cells in thought to be badness!
Gross
- May be patchy/multifocal.
- Multiple cystic spaces.
Microscopic
Features:
- Pancreatic duct lining cells jut into the duct lumen - papillomatous growth pattern.
- Cytology:
- Cell enlargement.
- Increased mucin production.
- Nuclear changes:
- Increased NC ratio.
- Nuclear crowding and pleomorphism.
- Mitotic activity.
- Cell enlargement.
Note:
- No ovarian type stroma underneath (as seen in mucinous tumours).
DDx:
- PanIN.
- Invasive ductal carcinoma of the pancreas.
- Intra-ampullary papillary-tubular neoplasm -- see ampulla of Vater.
See also
References
- ↑ Maire F, Hammel P, Terris B, et al. (November 2002). "Prognosis of malignant intraductal papillary mucinous tumours of the pancreas after surgical resection. Comparison with pancreatic ductal adenocarcinoma". Gut 51 (5): 717–22. PMC 1773420. PMID 12377813. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12377813.
- ↑ Baiocchi GL, Portolani N, Missale G, et al. (2010). "Intraductal papillary mucinous neoplasm of the pancreas (IPMN): clinico-pathological correlations and surgical indications". World J Surg Oncol 8: 25. doi:10.1186/1477-7819-8-25. PMC 2858722. PMID 20374620. http://wjso.com/content/8/1/25.
- ↑ Ikeuchi, N.; Itoi, T.; Sofuni, A.; Itokawa, F.; Tsuchiya, T.; Kurihara, T.; Ishii, K.; Tsuji, S. et al. (Apr 2010). "Prognosis of cancer with branch duct type IPMN of the pancreas.". World J Gastroenterol 16 (15): 1890-5. PMID PMC = 2856831 20397268 PMC = 2856831.
- ↑ Basturk O, Tan M, Bhanot U, Allen P, Adsay V, Scott SN, Shah R, Berger MF, Askan G, Dikoglu E, Jobanputra V, Wrzeszczynski KO, Sigel C, Iacobuzio-Donahue C, Klimstra DS. (2016). "The oncocytic subtype is genetically distinct from other pancreatic intraductal papillary mucinous neoplasm subtypes". Mod Pathol 29: 1058-69. PMID 27282351.