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1. Kent TS, Jr CM, Callery MP: Intraductal papillary mucinous neoplasm and the pancreatic incidentaloma. World J Gastrointest Surg; 2010 Oct 27;2(10):319-23
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  • [Title] Intraductal papillary mucinous neoplasm and the pancreatic incidentaloma.
  • Asymptomatic pancreatic lesions (APL) are a commonly encountered problem in today's pancreatic surgical practices.
  • Current literature regarding etiologies and incidence of APLs, particularly intraductal papillary mucinous neoplasm (IPMN), is presented.
  • APLs constitute a wide spectrum of pathology (solid/cystic, benign/premalignant/malignant) but, overall, IPMN is now the most common diagnosis.
  • The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are presented.
  • The importance of traditionally analyzed cyst characteristics including size, presence of mucin or nodules and cyst fluid aspirate as indicators of malignancy is emphasized, noting also the potential correlation of main duct dilatation, thickened septae and elevated cyst fluid CEA with increased risk of malignancy.

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  • (PMID = 21160837.001).
  • [ISSN] 1948-9366
  • [Journal-full-title] World journal of gastrointestinal surgery
  • [ISO-abbreviation] World J Gastrointest Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC2999207
  • [Keywords] NOTNLM ; Intraductal papillary mucinous neoplasm / Observation / Pancreatic incidentaloma / Surveillance
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2. Oku T, Maeda M, Wada Y, Waga E, Ono K, Nagamachi Y, Fujii S, Fujita M, Misu K, Senmaru N, Suzuki Y, Nagashima K, Niitsu Y: Intraductal oncocytic papillary neoplasm having clinical characteristics of mucinous cystic neoplasm and a benign histology. JOP; 2007;8(2):206-13
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  • [Title] Intraductal oncocytic papillary neoplasm having clinical characteristics of mucinous cystic neoplasm and a benign histology.
  • CONTEXT: An intraductal oncocytic papillary neoplasm is a rare pancreatic tumor which was first described by Adsay et al. in 1996.
  • Microscopically, the cyst was lined by columnar epithelium similar to pancreatic duct epithelium, and the nodular projection consisted of arborizing papillary structures, lined by plump cells with abundant eosinophilic cytoplasm.
  • The cellular atypism was mild and the proliferating index was low, compatible with adenoma of an intraductal oncocytic papillary neoplasm.
  • Although no ovarian type stroma was identified, in our case, no communication to main pancreatic duct (located in the pancreatic body) and rapid growth by intracystic hemorrhage were clinical characteristics of a mucinous cystic neoplasm, but not IPMN.
  • CONCLUSION: With only 17 cases reported to date, the clinical and pathological details of an intraductal oncocytic papillary neoplasm are still unclear.
  • To our knowledge, this is the first case report of an intraductal oncocytic papillary neoplasm with the clinical characteristics of a mucinous cystic neoplasm.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Cystadenocarcinoma, Mucinous / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 17356245.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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3. Allen PJ, Qin LX, Tang L, Klimstra D, Brennan MF, Lokshin A: Pancreatic cyst fluid protein expression profiling for discriminating between serous cystadenoma and intraductal papillary mucinous neoplasm. Ann Surg; 2009 Nov;250(5):754-60
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  • [Title] Pancreatic cyst fluid protein expression profiling for discriminating between serous cystadenoma and intraductal papillary mucinous neoplasm.
  • BACKGROUND: Many patients with benign serous cystadenoma (SCA) of the pancreas will undergo resection because of the inability to reliably discriminate between SCA and premalignant mucinous cysts (intraductal papillary mucinous neoplasm [IPMN], mucinous cystic neoplasm [MCN]).
  • METHODS: Cyst fluid from patients with SCA (n = 15), non main-duct and noninvasive IPMN (n = 32), and noninvasive MCN (n = 12) was aspirated at the time of operative resection and analyzed.
  • Commercially available and custom designed multiplex assays (Luminex) were performed using a biomarker panel developed for pancreatic cancer.

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  • (PMID = 19806054.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA098642; United States / NCI NIH HHS / CA / R01 CA108990; United States / NCI NIH HHS / CA / U01 CA117452; United States / NCI NIH HHS / CA / U01 CA08496
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Neoplasm Proteins
  • [Other-IDs] NLM/ NIHMS718468; NLM/ PMC4556365
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4. Dumitrescu D, Săftoiu A, Stoica M, Ciurea T, Popescu C: Natural evolution of an intraductal papillary mucinous neoplasm of the pancreas. A case report. J Gastrointestin Liver Dis; 2007 Mar;16(1):105-8
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  • [Title] Natural evolution of an intraductal papillary mucinous neoplasm of the pancreas. A case report.
  • Intraductal papillary mucinous neoplasms include a large spectrum of lesions communicating with the Wirsung duct, having a variable invasiveness from benign or borderline, to malignant (carcinoma in situ and invasive cancer).
  • Imaging studies (transabdominal ultrasonography, CT scanning, MR cholangiopancreatography) showed a macrocystic, multilocular, corporeal tumor, communicating with the retrograde dilated Wirsung duct.
  • EUS revealed hypoechoic material inside the cysts, raising the suspicion of an intraductal papillary mucinous neoplasm.
  • The imaging evaluation was repeated after two years, showing a rapid evolution of the tumor.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 17410297.001).
  • [ISSN] 1841-8724
  • [Journal-full-title] Journal of gastrointestinal and liver diseases : JGLD
  • [ISO-abbreviation] J Gastrointestin Liver Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
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5. Rodriguez JR, Salvia R, Crippa S, Warshaw AL, Bassi C, Falconi M, Thayer SP, Lauwers GY, Capelli P, Mino-Kenudson M, Razo O, McGrath D, Pederzoli P, Fernández-Del Castillo C: Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection. Gastroenterology; 2007 Jul;133(1):72-9; quiz 309-10
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  • [Title] Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection.
  • BACKGROUND & AIMS: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas arising in branch ducts are thought to be less aggressive than their main-duct counterparts, and guidelines for their conservative management were recently proposed.
  • This study describes the combined experience of 2 tertiary centers with branch-duct IPMNs aiming to validate these recommendations.
  • METHODS: A review of 145 patients with resected, pathologically confirmed, branch-duct IPMNs between 1990 and 2005 was conducted.
  • Median age was similar between benign and malignant subgroups (66 vs 67.5 years, respectively).
  • Jaundice was more frequent in patients with cancer (12.5% vs 1.8%, respectively, P = .022) and abdominal pain in patients with benign tumors (45% vs 25%, respectively, P = .025).
  • Findings associated with malignancy were the presence of a thick wall (P < .001), nodules (P < .001), and tumor diameter >or=30 mm (P < .001).
  • After a mean follow-up of 45 months, the 5-year disease-specific survival for branch-duct IPMNs with noninvasive neoplasms was 100% and, for invasive cancer, was 63%.
  • CONCLUSIONS: This large cohort of resected branch-duct IPMNs shows that cancer is present in 22% of cases and validates the recent guidelines that indicate absence of malignancy in tumors <30 mm, without symptoms or mural nodules.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adenoma / mortality. Adenoma / pathology. Adenoma / surgery. Adult. Aged. Aged, 80 and over. Carcinoma in Situ / mortality. Carcinoma in Situ / pathology. Carcinoma in Situ / surgery. Cohort Studies. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / mortality. Postoperative Complications / mortality. Practice Guidelines as Topic / standards. Survival Analysis

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  • (PMID = 17631133.001).
  • [ISSN] 0016-5085
  • [Journal-full-title] Gastroenterology
  • [ISO-abbreviation] Gastroenterology
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / K08 DK071329
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS519078; NLM/ PMC3807096
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6. Sai JK, Suyama M, Kubokawa Y, Watanabe S, Maehara T: Pancreatic-duct-lavage cytology in candidates for surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas: should the International Consensus Guidelines be revised? Gastrointest Endosc; 2009 Mar;69(3 Pt 1):434-40
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  • [Title] Pancreatic-duct-lavage cytology in candidates for surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas: should the International Consensus Guidelines be revised?
  • BACKGROUND: The International Consensus Guidelines are helpful for the management of branch-duct intraductal papillary mucinous neoplasms (IPMNs), because they allow us to exclude malignancy.
  • However, it is not possible to predict malignancy with certainty, and further preoperative differentiation between benign and malignant IPMNs is required to avoid the false-positive results.
  • OBJECTIVE: To examine the usefulness of pancreatic-duct-lavage cytology by using an originally designed double-lumen catheter for discriminating benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines.
  • PATIENTS: Pancreatic-duct-lavage cytology was investigated in 24 patients with branch-duct IPMNs who underwent surgical resection based on the International Consensus Guidelines, namely, they either had intramural nodules or the ectatic branch duct was >30 mm in diameter.
  • MAIN OUTCOME MEASUREMENTS: The sensitivity and specificity of pancreatic-duct-lavage cytology for discriminating benign from malignant IPMNs.
  • RESULTS: More than 30 mL of pancreatic-duct-lavage fluid was obtained from each patient, and there were no patients with noninformative results.
  • CONCLUSIONS: Pancreatic-duct-lavage cytology can improve differentiation between benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Pancreatic Ducts. Pancreatic Neoplasms / pathology. Practice Guidelines as Topic

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  • [CommentIn] Gastrointest Endosc. 2009 Mar;69(3 Pt 1):441-3 [19231485.001]
  • (PMID = 18684453.001).
  • [ISSN] 1097-6779
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Uchida N, Kamada H, Tsutsui K, Ono M, Aritomo Y, Masaki T, Kushida Y, Haba R, Nakatsu T, Kuriyama S: Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma. J Gastroenterol; 2007 Aug;42(8):657-62
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  • [Title] Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma.
  • BACKGROUND: The aim of this study was to evaluate the usefulness of pancreatic duct brushing for diagnosis of pancreatic carcinoma.
  • METHODS: Brush cytology was attempted in 58 patients suspected of having pancreatic malignancy because of stricture of the main pancreatic duct, confirmed by endoscopic retrograde cholangiopancreatography.
  • Thirty-eight patients were finally diagnosed by an operation or the clinical course as having pancreatic carcinoma, and the remaining 20 patients as having chronic pancreatitis.
  • The usefulness of brush cytology for diagnosis of pancreatic carcinoma was estimated.
  • We interpreted failures of pancreatic duct brushing to be false negatives when the lesion was malignant.
  • Brush cytology was positive in 25 of 38 patients with pancreatic carcinoma (sensitivity 65.8%) and negative in all patients without malignancy (specificity 100%).
  • Moreover, the sensitivity in 2001-2005 was 85.7% if failures of brushing with pancreatic carcinoma are excluded.
  • CONCLUSIONS: Although further studies with a large number of patients are needed, our results suggest that with recent improvements of the brushing technique, pancreatic duct brushing is a useful and safe method for the differential diagnosis of malignancy from benign diseases of the pancreas.
  • [MeSH-major] Biopsy / utilization. Carcinoma / pathology. Endoscopy, Digestive System / methods. Pancreatic Ducts / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Neoplasm Staging. Reproducibility of Results. Retrospective Studies

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  • (PMID = 17701129.001).
  • [ISSN] 0944-1174
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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8. Satoh K, Hamada S, Kanno A, Hirota M, Umino J, Ito H, Masamune A, Egawa S, Unno M, Shimosegawa T: Expression of MSX2 predicts malignancy of branch duct intraductal papillary mucinous neoplasm of the pancreas. J Gastroenterol; 2010 Jul;45(7):763-70
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  • [Title] Expression of MSX2 predicts malignancy of branch duct intraductal papillary mucinous neoplasm of the pancreas.
  • BACKGROUND: To distinguish malignant from benign branch duct (BD)-intraductal papillary mucinous neoplasm (IPMN) still remains difficult.
  • Recently, we revealed that MSX2 was frequently expressed in pancreatic cancer and its expression was correlated with aggressive behavior of the cancer.
  • The aim of this study was to assess the involvement of MSX2 in IPMN development and whether its expression would differentiate malignant from benign IPMN.
  • The role of MSX2 in the pancreatic duct cell was assessed by the induced expression of MSX2 in a normal human pancreatic duct epithelial cell line (HPDE).
  • RESULTS: Malignant IPMN expressed significantly higher levels of MSX2 mRNA than benign IPMN lesions.
  • MSX2 protein expression was frequently found in borderline and malignant lesions (20/29, 68.9%), while its expression was seen in only one of 16 benign IPMN tissues.
  • CONCLUSIONS: Based on our results, MSX2 plays a pivotal role in the development of IPMN through growth stimulation of tumor cells, and its expression was identified as an independent predictive factor for malignancy of BD-IPMN.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / genetics. Carcinoma, Papillary / genetics. Homeodomain Proteins / genetics. Pancreatic Neoplasms / genetics
  • [MeSH-minor] Adenocarcinoma, Mucinous / genetics. Adenocarcinoma, Mucinous / pathology. Aged. Cell Line. Cell Proliferation. Epithelial Cells / metabolism. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Multivariate Analysis. Pancreatic Ducts / cytology. Pancreatic Ducts / metabolism. Pancreatic Ducts / pathology. Predictive Value of Tests. RNA, Messenger / metabolism. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 20107842.001).
  • [ISSN] 1435-5922
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Homeodomain Proteins; 0 / MSX2 protein; 0 / RNA, Messenger
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9. Manfredi R, Graziani R, Motton M, Mantovani W, Baltieri S, Tognolini A, Crippa S, Capelli P, Salvia R, Pozzi Mucelli R: Main pancreatic duct intraductal papillary mucinous neoplasms: accuracy of MR imaging in differentiation between benign and malignant tumors compared with histopathologic analysis. Radiology; 2009 Oct;253(1):106-15
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  • [Title] Main pancreatic duct intraductal papillary mucinous neoplasms: accuracy of MR imaging in differentiation between benign and malignant tumors compared with histopathologic analysis.
  • PURPOSE: To retrospectively determine the accuracy of magnetic resonance (MR) imaging combined with MR cholangiopancreatography (CP) in differentiating benign from malignant intraductal papillary mucinous neoplasms (IPMNs) involving the main pancreatic duct (MPD), with histopathologic analysis as the reference standard.
  • Qualitative image analysis included assessment of the site of MPD dilatation (head of the pancreas, body and/or tail of the pancreas, or diffuse), presence or absence of duct wall nodules, and contrast enhancement of the MPD walls.
  • MPD wall nodules were observed in 16 carcinomas involving the MPD and one adenoma or borderline neoplasm (P < .00001).
  • Duct wall enhancement was observed in 20 MPD or mixed type carcinomas and five adenomas or borderline neoplasms (P = .0001).
  • The median maximal diameter of the MPD was 18 mm in malignant MPD or mixed type IPMNs and 11 mm in benign borderline IPMNs (P = .038).
  • CONCLUSION: Duct wall nodules and enhancement of the MPD walls are signs of malignant MPD or mixed type IPMNs.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Cholangiopancreatography, Magnetic Resonance. Magnetic Resonance Imaging / methods. Pancreatic Ducts / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 19703865.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Magnetite Nanoparticles; 0 / Siloxanes; 0 / ferumoxsil; XM0M87F357 / Ferrosoferric Oxide
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10. Kim SH, Lim JH, Lee WJ, Lim HK: Macrocystic pancreatic lesions: differentiation of benign from premalignant and malignant cysts by CT. Eur J Radiol; 2009 Jul;71(1):122-8
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  • [Title] Macrocystic pancreatic lesions: differentiation of benign from premalignant and malignant cysts by CT.
  • OBJECTIVE: To assess useful CT features for differentiating benign from premalignant and malignant macrocystic pancreatic lesions.
  • METHODS: Seventy-four patients with pathologically proven macrocystic pancreatic lesions were enrolled: 17 benign cysts (macrocystic serous cystadenoma, n=12; congenital cyst; n=5) and 57 premalignant and malignant cysts (mucinous cystic neoplasm, n=28; intraductal papillary mucinous neoplasm of branch duct type, n=20; tumor with cystic change, n=9).
  • RESULTS: On univariate analysis, the differences for the shape (p=0.007), wall thickness (p=0.011), and internal surface (p=0.012) between benign and premalignant and malignant cysts were significant.
  • A lobulated shape, a thin wall and a smooth internal surface were more frequent in benign cysts, whereas a round or oval shape or a complex cystic shape with tubular cyst, a thick wall and an irregular internal surface were more frequent in premalignant and malignant cysts.
  • On multivariate analysis, the shape (p=0.002) and wall thickness (p=0.025) were significant CT features for differentiating benign from premalignant and malignant cysts.
  • CONCLUSION: Shape and wall thickness are the main CT features for differentiating benign from premalignant and malignant macrocystic pancreatic lesions.
  • [MeSH-major] Algorithms. Pancreatic Cyst / radiography. Pancreatic Neoplasms / radiography. Precancerous Conditions / radiography. Radiographic Image Interpretation, Computer-Assisted / methods. Tomography, X-Ray Computed / methods

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  • (PMID = 18448299.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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11. Ellis CT, Barbour JR, Shary TM, Adams DB: Pancreatic cyst: pseudocyst or neoplasm? Pitfalls in endoscopic retrograde cholangiopancreatography diagnosis. Am Surg; 2010 Jul;76(7):725-30
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  • [Title] Pancreatic cyst: pseudocyst or neoplasm? Pitfalls in endoscopic retrograde cholangiopancreatography diagnosis.
  • Pancreatic pseudocysts represent the majority of cystic lesions, and can usually be differentiated from cystic neoplasms, which have malignant potential.
  • When ERCP demonstrates cyst communication with the pancreatic duct, the diagnosis of pseudocyst is usually secure.
  • A retrospective chart review was conducted of two patients undergoing distal pancreatectomy in 2008 to 2009 for cystic lesions communicating with the main pancreatic duct on ERCP.
  • Radiologic imaging showed cystic lesions in the pancreatic tail.
  • ERCP demonstrated main pancreatic duct communication.
  • The conventional wisdom that a pancreatic cyst communicating with the main pancreatic duct is a benign pseudocyst is not always wise.
  • As seen in this series, mucinous cystadenomas can erode into the main pancreatic duct.
  • Women in the fourth and fifth decade with symptomatic cysts in the pancreatic tail with a history of pancreatitis should undergo distal pancreatectomy, regardless of ductal communication on ERCP.
  • [MeSH-major] Cholangiopancreatography, Endoscopic Retrograde. Cystadenoma, Mucinous / radiography. Pancreatic Neoplasms / radiography. Pancreatic Pseudocyst / radiography

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  • (PMID = 20698379.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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12. Gill KR, Pelaez-Luna M, Keaveny A, Woodward TA, Wallace MB, Chari ST, Smyrk TC, Takahashi N, Clain JE, Levy MJ, Pearson RK, Petersen BT, Topazian MD, Vege SS, Kendrick M, Farnell MB, Raimondo M: Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients. Am J Gastroenterol; 2009 May;104(5):1256-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Branch duct intraductal papillary mucinous neoplasm of the pancreas in solid organ transplant recipients.
  • OBJECTIVES: In immunosuppressed patients with branch duct intraductal papillary mucinous neoplasm (IPMN-Br) associated with solid organ transplantation, the risk of major pancreatic surgery has to be weighed against the risk of progression to malignancy.
  • Only one NT-IPMN-Br patient was diagnosed with malignancy; all others had benign IPMN-Br.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Immunocompromised Host. Organ Transplantation / adverse effects. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Aged. Analysis of Variance. Case-Control Studies. Cholangiopancreatography, Endoscopic Retrograde. Endosonography. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Pancreatectomy / adverse effects. Pancreatectomy / methods. Postoperative Complications / mortality. Probability. Prognosis. Risk Assessment. Survival Analysis. Transplantation Immunology. Treatment Outcome


13. Jausset F, Delvaux M, Dumitriu D, Bressenot A, Bruot O, Mathias J, Regent D, Laurent V: Benign intraductal papillary-mucinous neoplasm of the pancreas associated with spontaneous pancreaticogastric and pancreaticoduodenal fistulas. Digestion; 2010;82(1):42-6
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  • [Title] Benign intraductal papillary-mucinous neoplasm of the pancreas associated with spontaneous pancreaticogastric and pancreaticoduodenal fistulas.
  • We report the case of a benign IPMN associated with pancreaticogastric and pancreaticoduodenal fistulas.
  • Computed tomography and MRI showed a large dilatation of the main pancreatic duct (>1 cm) with intraductal nodules, and pancreaticogastric and pancreaticoduodenal fistulas.
  • The histopathological examination of the surgical specimen showed a benign IPMN.
  • This case proves that a benign IPMN can cause pancreaticogastric and pancreaticoduodenal fistulas, probably resulting from mechanical factors.
  • [MeSH-major] Adenocarcinoma, Mucinous / complications. Carcinoma, Pancreatic Ductal / complications. Carcinoma, Papillary / complications. Duodenal Diseases / etiology. Gastric Fistula / etiology. Intestinal Fistula / etiology. Pancreatic Fistula / etiology. Pancreatic Neoplasms / complications

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  • [Copyright] 2010 S. Karger AG, Basel.
  • (PMID = 20203511.001).
  • [ISSN] 1421-9867
  • [Journal-full-title] Digestion
  • [ISO-abbreviation] Digestion
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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14. Fukunaga N, Ishikawa M, Minato T, Yamamura Y, Ishikura H, Ichimori T, Kimura S, Sakata A, Fujii Y: Lymphoepithelial cyst of the pancreas that was difficult to distinguish from branch duct-type intraductal papillary mucinous neoplasm: report of a case. Surg Today; 2009;39(10):901-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Lymphoepithelial cyst of the pancreas that was difficult to distinguish from branch duct-type intraductal papillary mucinous neoplasm: report of a case.
  • The tumor markers, including DUPAN 2, SPAN-1, and carbohydrate antigen 19-9, were within the normal ranges.
  • Endoscopic retrograde cholangiopancreatography showed that the main pancreatic duct was normal.
  • Based on these findings, we suspected a branch duct type intraductal papillary mucinous neoplasm.
  • Pathologically, the cyst wall was lined with squamous epithelium surrounded by abundant lymphoid tissue with follicles, consistent with a lymphoepithelial cyst of the pancreas, which is an unusual benign cyst.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Pancreatic Cyst / diagnosis. Pancreatic Neoplasms / diagnosis

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  • (PMID = 19784732.001).
  • [ISSN] 1436-2813
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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15. Takeshita K, Kutomi K, Takada K, Haruyama T, Fukushima J, Aida R, Takada T, Furui S: Differential diagnosis of benign or malignant intraductal papillary mucinous neoplasm of the pancreas by multidetector row helical computed tomography: evaluation of predictive factors by logistic regression analysis. J Comput Assist Tomogr; 2008 Mar-Apr;32(2):191-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Differential diagnosis of benign or malignant intraductal papillary mucinous neoplasm of the pancreas by multidetector row helical computed tomography: evaluation of predictive factors by logistic regression analysis.
  • OBJECTIVE: The purpose of this study is to evaluate predictive factors for discriminating benign from malignant intraductal mucin-producing neoplasm (IPMN) of the pancreas on multidetector row computed tomography (MDCT).
  • In patients with branch duct-type tumors, sex and age of the patient, location, shape, size and multiplicity of the cystic lesion, presence of mural nodule, and maximum diameter of main pancreatic duct (MPD) dilatation were evaluated by logistic regression analysis.
  • RESULTS: Tumors were classified as main duct-type (n = 7) and branch duct-type (n = 46).
  • Among main duct-type tumors, all 7 lesions were diagnosed as malignant.
  • Among 46 lesions of branch-type IPMN, 8 lesions were malignant, and 38 lesions were benign.
  • On adjusted logistic regression analysis, combination factor of main duct dilatation and mural nodule or large cystic size had statistical significance for the risk of malignancy in branch duct-type IPMN.
  • CONCLUSIONS: Main duct-type IPMN is highly suggestive for malignancy.
  • Combination factors of main ductal dilation and mural nodule, and main ductal dilation, and large cystic tumor size are thought to be predictive factors for malignant branch-type IPMN.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Carcinoma, Papillary / diagnosis. Pancreatic Neoplasms / diagnosis. Tomography, Spiral Computed / methods. Tomography, Spiral Computed / statistics & numerical data

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  • (PMID = 18379300.001).
  • [ISSN] 0363-8715
  • [Journal-full-title] Journal of computer assisted tomography
  • [ISO-abbreviation] J Comput Assist Tomogr
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 4419T9MX03 / Iohexol
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16. Augustin T, Vandermeer TJ: Intraductal papillary mucinous neoplasm: a clinicopathologic review. Surg Clin North Am; 2010 Apr;90(2):377-98

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraductal papillary mucinous neoplasm: a clinicopathologic review.
  • Intraductal papillary mucinous neoplasm (IPMN) is an intraductal mucin-producing epithelial neoplasm that arises from the main pancreatic duct (MD-IPMN), secondary branch ducts (BD-IPMN), or both (mixed type; Mix-IPMN).
  • Neoplastic progression from benign adenoma to invasive adenocarcinoma has not been proven but is generally thought to occur.
  • At present, treatment options for patients with IPMN range from observation to pancreatic resection depending on the natural history of the lesion.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology
  • [MeSH-minor] Algorithms. Biopsy, Fine-Needle / methods. Cholangiopancreatography, Endoscopic Retrograde. Diagnostic Imaging. Dilatation, Pathologic. Disease Progression. Endosonography. Epithelium / pathology. Humans. Mucins / metabolism. Neoplasm Invasiveness. Pancreatic Ducts / pathology. Survival Analysis

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  • (PMID = 20362793.001).
  • [ISSN] 1558-3171
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Mucins
  • [Number-of-references] 96
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17. Tanaka M, Kobayashi K, Mizumoto K, Yamaguchi K: Clinical aspects of intraductal papillary mucinous neoplasm of the pancreas. J Gastroenterol; 2005 Jul;40(7):669-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical aspects of intraductal papillary mucinous neoplasm of the pancreas.
  • Intraductal papillary mucinous neoplasm (IPMN) is a spectrum of neoplasia in the pancreatic duct epithelium characterized by cystic dilation of the main and/or branch pancreatic duct.
  • According to the site of involvement IPMNs are classified into three categories, i.e., main duct type, branch duct type, and combined type.
  • Most branch duct IPMNs are benign, whereas the other two types are often malignant.
  • A large size of branch duct IPMN and marked dilation of the main pancreatic duct indicate the presence of adenoma at least.
  • The prognosis is favorable after complete resection of benign and noninvasive malignant IPMNs.
  • On the other hand, asymptomatic branch duct IPMNs without mural nodules can be observed without resection for a considerably long time.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Pancreatectomy / methods. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Age Distribution. Aged. Aged, 80 and over. Cholangiopancreatography, Endoscopic Retrograde / methods. Endosonography / methods. Female. Humans. Immunohistochemistry. Incidence. Male. Middle Aged. Neoplasm Staging. Prognosis. Risk Assessment. Sex Distribution. Survival Analysis

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  • (PMID = 16082582.001).
  • [ISSN] 0944-1174
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 58
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18. Ge C, Luo X, Chen X, Guo K: Enucleation of pancreatic cystadenomas. J Gastrointest Surg; 2010 Jan;14(1):141-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Enucleation of pancreatic cystadenomas.
  • BACKGROUND: Optimal surgical treatment of pancreatic cystadenomas is controversial due to the rarity of the tumors and paucity of studies regarding long-term outcomes.
  • This is especially true for large pancreatic cystadenomas.
  • The objective of this study was to determine the safety and effectiveness of treating pancreatic cystadenomas by enucleation.
  • METHODS: Eleven cases of pancreatic mucinous or serous cystadenomas were selected for enucleation according to the following criteria:.
  • (1) the benign nature of the tumors was ascertained preoperatively and intraoperatively, (2) small tumors or larger tumors no more than 6 cm in diameter growing outwardly with small tumor beds, and (3) the main pancreatic duct was not in jeopardy of damage by enucleation.
  • The patients' demographics, tumor features, morbidity, and follow-up results were retrospectively reviewed and analyzed.
  • All cases were followed up from 23 to 67 months, which revealed no neoplasm recurrence or new onset of diabetes mellitus; one patient developed a pseudocyst in the body 30 months after enucleation.
  • CONCLUSIONS: It is safe and effective to perform enucleation for well-selected benign pancreatic cystadenomas even if the tumor size is as large as 6 cm, and the endocrine or exocrine function of the pancreas is maintained as much as possible.
  • [MeSH-major] Cystadenoma, Mucinous / surgery. Cystadenoma, Serous / surgery. Pancreatic Neoplasms / surgery

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  • (PMID = 19779948.001).
  • [ISSN] 1873-4626
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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19. Rodriguez S, Faigel D: Absence of a dilated duct predicts benign disease in suspected pancreas cancer: a simple clinical rule. Dig Dis Sci; 2010 Apr;55(4):1161-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Absence of a dilated duct predicts benign disease in suspected pancreas cancer: a simple clinical rule.
  • BACKGROUND: Pancreatic cancer can be difficult to diagnose.
  • METHODS: Patients presenting for endoscopic ultrasound (EUS) evaluation for suspected pancreatic mass were prospectively enrolled.
  • Thirty-three patients had cancer and 40 had benign disease.
  • On multivariate analysis, only vascular or organ invasion and dilation of the pancreatic duct (PD) were significantly associated with cancer.
  • CONCLUSIONS: The most significant negative predictive endosonographic finding in patients with suspected pancreatic cancer is a non-dilated PD.
  • If a patient with suspected pancreatic cancer does not have a dilated PD and the FNA is negative for malignancy, the likelihood of cancer is low.
  • [MeSH-major] Carcinoma, Acinar Cell / ultrasonography. Carcinoma, Pancreatic Ductal / ultrasonography. Endosonography. Pancreatic Ducts / ultrasonography. Pancreatic Neoplasms / ultrasonography
  • [MeSH-minor] Aged. Biopsy, Fine-Needle. Diagnosis, Differential. Dilatation, Pathologic / pathology. Dilatation, Pathologic / ultrasonography. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Invasiveness. Pancreas / pathology. Pancreas / ultrasonography. Pancreatic Diseases / pathology. Pancreatic Diseases / ultrasonography. Predictive Value of Tests. Prospective Studies

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  • (PMID = 19590960.001).
  • [ISSN] 1573-2568
  • [Journal-full-title] Digestive diseases and sciences
  • [ISO-abbreviation] Dig. Dis. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Iglesias-García J: [Pancreatic tumors]. Gastroenterol Hepatol; 2008 Oct;31 Suppl 4:83-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Pancreatic tumors].
  • The management of pancreatic cancer is complex and prognosis is poor.
  • The etiopathogenesis of pancreatic cancer has been related to several factors, such as diabetes mellitus, smoking and alcohol use, the presence of pancreatic cystic lesions and distinct genetic syndromes.
  • The development of EUS and EUS-guided fine-needle aspiration has been crucial in cystic pancreatic tumors, especially in distinguishing benign from malignant lesions or those with potential for malignant transformation (presence of mural modules, dilatation of the main pancreatic duct, the presence of masses, CEA levels, etc.).
  • [MeSH-major] Pancreatic Neoplasms
  • [MeSH-minor] Humans. Neoplasm Staging. Pancreatic Cyst / diagnosis. Pancreatic Cyst / therapy. Prognosis

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  • (PMID = 19434873.001).
  • [ISSN] 0210-5705
  • [Journal-full-title] Gastroenterología y hepatología
  • [ISO-abbreviation] Gastroenterol Hepatol
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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21. Agarwal B, Krishna NB, Labundy JL, Safdar R, Akduman EI: EUS and/or EUS-guided FNA in patients with CT and/or magnetic resonance imaging findings of enlarged pancreatic head or dilated pancreatic duct with or without a dilated common bile duct. Gastrointest Endosc; 2008 Aug;68(2):237-42; quiz 334, 335
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] EUS and/or EUS-guided FNA in patients with CT and/or magnetic resonance imaging findings of enlarged pancreatic head or dilated pancreatic duct with or without a dilated common bile duct.
  • BACKGROUND: Incidental findings of an enlarged head of pancreas (HOP) or dilated pancreatic duct (PD) with or without a dilated common bile duct (CBD) on CT or magnetic resonance imaging (MRI), in patients without obstructive jaundice, raise suspicion for a pancreatic neoplasm, but their clinical significance has not been established.
  • OBJECTIVE: To determine the prevalence of pancreatic neoplasm in this patient group.
  • INTERVENTIONS: An EUS examination was performed by using a radial echoendoscopy followed by a linear echoendoscopy, if a focal pancreatic lesion was identified.
  • (1) The prevalence of pancreatic neoplasms and (2) performance characteristics of EUS-FNA for identifying malignant neoplasm, in this patient group.
  • RESULTS: In 110 study patients, the final diagnosis included adenocarcinoma (n = 7), pancreatic intraepithelial neoplasia (n = 1), neuroendocrine tumor (n = 1), tumor metastasis (n = 1), and benign cyst (n = 3).
  • The accuracy of EUS and EUS-FNA for diagnosing pancreatic neoplasm in these patients was 99.1%, with 88.8% sensitivity, 100% specificity, 99% negative predicative value, and 100% positive predictive value.
  • CONCLUSION: A pancreatic neoplasm is seen in a clinically significant number of patients with "enlarged HOP" or "dilated PD with or without a dilated CBD" but without obstructive jaundice.
  • EUS-FNA seems highly accurate for diagnosing pancreatic neoplasm in these patients.
  • [MeSH-major] Adenocarcinoma / diagnosis. Biopsy, Fine-Needle / methods. Diagnostic Imaging / methods. Endosonography / methods. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Age Distribution. Aged. Cohort Studies. Common Bile Duct / pathology. Common Bile Duct / ultrasonography. Female. Humans. Immunohistochemistry. Incidence. Magnetic Resonance Imaging / methods. Male. Middle Aged. Pancreatic Ducts / pathology. Pancreatic Ducts / ultrasonography. Pancreatitis / diagnosis. Pancreatitis / epidemiology. Prognosis. Retrospective Studies. Risk Factors. Sensitivity and Specificity. Sex Distribution. Survival Analysis. Tomography, X-Ray Computed / methods

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  • [CommentIn] Endoscopy. 2010 Jan;42(1):68-72 [20066593.001]
  • (PMID = 18423464.001).
  • [ISSN] 1097-6779
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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22. Kawamoto S, Horton KM, Lawler LP, Hruban RH, Fishman EK: Intraductal papillary mucinous neoplasm of the pancreas: can benign lesions be differentiated from malignant lesions with multidetector CT? Radiographics; 2005 Nov-Dec;25(6):1451-68; discussion 1468-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraductal papillary mucinous neoplasm of the pancreas: can benign lesions be differentiated from malignant lesions with multidetector CT?
  • Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a distinct clinicopathologic entity that is being recognized with increasing frequency.
  • Features predictive of invasive carcinoma in IPMN at CT and other imaging studies include involvement of the main pancreatic duct, marked dilatation of the main pancreatic duct, diffuse or multifocal involvement, the presence of a large mural nodule or solid mass, large size of the mass, and obstruction of the common bile duct.
  • [MeSH-major] Carcinoma, Intraductal, Noninfiltrating / radiography. Carcinoma, Papillary / radiography. Neoplasms, Multiple Primary / radiography. Pancreatic Neoplasms / radiography. Tomography, X-Ray Computed

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  • [Copyright] RSNA, 2005.
  • (PMID = 16284127.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 43
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23. Ichimura T, Kondo S, Okamura K, Tanaka E, Hirano S: Total parenchymal pancreatectomy preserving the duodenum, choledochus and spleen for widespread intraductal papillary mucinous neoplasm: report of a case. Hepatogastroenterology; 2010 Jan-Feb;57(97):8-11
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Total parenchymal pancreatectomy preserving the duodenum, choledochus and spleen for widespread intraductal papillary mucinous neoplasm: report of a case.
  • For patients with benign or low malignant diseases of the pancreas, several organ-preserving surgical techniques of pancreatectomy have been presented for localized lesions.
  • We herein report a patient with widespread intraductal papillary mucinous neoplasm treated successfully with total parenchymal pancreatectomy.
  • A 73-year-old man was diagnosed as main duct intraductal papillary mucinous neoplasm.
  • A papillary tumor was located in the body of the pancreas, and intraepithelial spreading reached almost the end of the pancreas tail and nearly over the midpoint of the pancreas head.
  • We performed total parenchymal pancreatectomy, an initial surgical procedure in which almost all parenchyma of the pancreas was resected but the duodenum, the common bile duct and the spleen were preserved and no reconstruction was needed.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Pancreatectomy. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Aged. Common Bile Duct. Duodenum. Humans. Male. Spleen

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  • (PMID = 20422863.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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24. Horiguchi A, Miyakawa S, Ishihara S, Ito M, Asano Y, Furusawa K, Shimizu T, Yamamoto T: Surgical design and outcome of duodenum-preserving pancreatic head resection for benign or low-grade malignant tumors. J Hepatobiliary Pancreat Sci; 2010 Nov;17(6):792-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical design and outcome of duodenum-preserving pancreatic head resection for benign or low-grade malignant tumors.
  • To apply duodenum-preserving pancreatic head resection (DPPHR) as radical procedure for benign or low-grade malignant tumors, it needs the reconciliation of complete pancreatic head resection and preservation of the bile duct and peripancreatic vessels.
  • Several modifications have been introduced and applied to remove these lesions, however, the techniques have not been made clear in the management of the peripancreatic vessels and the bile duct.
  • The long-term outcomes of the DPPHR have been reported as extremely rare in comparison with pylorus preserving pancreatoduodenectomy (PPPD) in these pancreatic head tumors.
  • Therefore, we modified the DPPHR to include a complete resection of the pancreatic head and the preservation of both anterior and posterior arterial arcades.
  • The bile duct is covered by the pancreatic parenchyma in various ways.
  • The techniques of the preservation of the bile duct are also introduced.
  • We performed 21 DPPHRs and 19 PPPDs in the patients with benign or low-grade malignant pancreatic head tumor.
  • The DPPHR should be favored over the PPPD in benign or low-grade malignant tumors of the head of the pancreas if there is no compromise with oncologic radicality.
  • [MeSH-major] Pancreatectomy / methods. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy / methods
  • [MeSH-minor] Angiography. Female. Follow-Up Studies. Humans. Laparotomy. Length of Stay. Male. Middle Aged. Neoplasm Staging. Pancreas / blood supply. Time Factors. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19894017.001).
  • [ISSN] 1868-6982
  • [Journal-full-title] Journal of hepato-biliary-pancreatic sciences
  • [ISO-abbreviation] J Hepatobiliary Pancreat Sci
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Japan
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25. Beger HG, Rau BM, Gansauge F, Schwarz M, Siech M, Poch B: Duodenum-preserving total pancreatic head resection for cystic neoplasm: a limited but cancer-preventive procedure. Langenbecks Arch Surg; 2008 Jul;393(4):589-98
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Duodenum-preserving total pancreatic head resection for cystic neoplasm: a limited but cancer-preventive procedure.
  • BACKGROUND: Cystic neoplastic lesions of the pancreas are found in up to 10% of all pancreatic lesions.
  • A malignant transformation of cystic neoplasia is observed in intraductal papillary mucinous tumor (IPMN) lesions in 60% and in mucinous cystic tumor (MCN) lesions in up to 30%.
  • For cystic neoplasia located monocentrically in the pancreatic head and that do not have an association with an invasive pancreatic cancer, the duodenum-preserving total head resection has been used in recent time as a limited surgical procedure.
  • PATIENTS: An indication to duodenum-preserving total pancreatic head resection is considered for patients who do not have clinical signs of an advanced cancer in the lesion and who have main-duct IPMN and monocentric MCN lesions.
  • In 104 patients with cystic neoplastic lesions in the Ulm series, 32% finally had a carcinoma in situ or an advanced pancreatic cancer.
  • The application of a duodenum-preserving total pancreatic head resection in patients with asymptomatic cystic lesion is based on the size of the tumor and the tumor relation to the pancreatic ducts.
  • RESULTS: Duodenum-preserving total pancreatic head resection is used in several modifications.
  • The surgical procedure is a limited pancreatic head resection which necessitates segmental resection of the peripapillary duodenum.
  • The long-term outcome is determined by completeness of resection for both -- benign and malignant -- entities.
  • CONCLUSION: A duodenum-preserving total pancreatic head resection is a limited surgical procedure for patients who suffer a local monocentric, cystic neoplastic lesion in the pancreatic head.
  • Absence of an advanced pancreatic cancer and completeness of extirpation of the benign tumor determine the long-term outcome.
  • In regards to the location of the lesion in the pancreatic head, several modifications have been applied with low hospital morbidity and mortality below 1%.

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  • (PMID = 18379818.001).
  • [ISSN] 1435-2451
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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26. Marrache F, Cazals-Hatem D, Kianmanesh R, Palazzo L, Couvelard A, O'Toole D, Maire F, Hammel P, Levy P, Sauvanet A, Ruszniewski P: Endocrine tumor and intraductal papillary mucinous neoplasm of the pancreas: a fortuitous association? Pancreas; 2005 Jul;31(1):79-83
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  • [Title] Endocrine tumor and intraductal papillary mucinous neoplasm of the pancreas: a fortuitous association?
  • OBJECTIVES: Pancreatic endocrine tumors (PETs) and intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are rare diseases of the pancreas.
  • RESULTS: Preoperative diagnosis was unspecified pancreatic tumor (n = 1), IPMN (n = 2), and association of PET and IPMN (n = 3).
  • IPMN involved the main pancreatic duct in 4 patients and was classified as benign (n = 4), borderline (n = 1), or malignant noninvasive (n = 1).
  • CONCLUSION: This study describes a new aspect of endocrine-exocrine pancreatic neoplasm association.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Endocrine Gland Neoplasms / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 15968252.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chromogranin A; 0 / Chromogranins; 9007-92-5 / Glucagon
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27. Ku YM, Shin SS, Lee CH, Semelka RC: Magnetic resonance imaging of cystic and endocrine pancreatic neoplasms. Top Magn Reson Imaging; 2009 Feb;20(1):11-8
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  • [Title] Magnetic resonance imaging of cystic and endocrine pancreatic neoplasms.
  • Magnetic resonance imaging is a useful diagnostic modality in the assessment of various pancreatic neoplasms.
  • Pancreatic endocrine tumors are moderately low in signal intensity on T1-weighted fat-suppressed images and moderately high in signal intensity on T2-weighted fat-suppressed images and demonstrate homogeneous, ring, or diffuse heterogeneous enhancement on immediate postgadolinium gradient echo images.
  • Cystic pancreatic neoplasms, including intraductal papillary mucinous neoplasm, are well demonstrated and subcategorized according to their characteristic cystic configurations on MRI and MR cholangiopancreatography images.
  • Mucinous cystic neoplasms usually appear as multilocular cystic masses, with benign forms of macrocystic tumors possessing uniform thickness septations and malignant forms exhibiting irregular septations and tumor nodules.
  • The presence of tumor stroma, invasion of adjacent tissue, or liver metastases can be assessed by MRI.
  • The connection between the pancreatic duct and the cystic tumor is usually well shown on MR cholangiopancreatography images.
  • [MeSH-major] Carcinoma, Adenoid Cystic / diagnosis. Carcinoma, Neuroendocrine / diagnosis. Cholangiopancreatography, Magnetic Resonance / methods. Cholangiopancreatography, Magnetic Resonance / trends. Image Enhancement / methods. Pancreas / pathology. Pancreatic Neoplasms / diagnosis

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  • (PMID = 19687721.001).
  • [ISSN] 1536-1004
  • [Journal-full-title] Topics in magnetic resonance imaging : TMRI
  • [ISO-abbreviation] Top Magn Reson Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 30
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28. Zhang J, Wang PJ, Yuan XD: Correlation between CT patterns and pathological classification of intraductal papillary mucinous neoplasm. Eur J Radiol; 2010 Jan;73(1):96-101
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  • [Title] Correlation between CT patterns and pathological classification of intraductal papillary mucinous neoplasm.
  • OBJECTIVE: To examine CT patterns of intraductal papillary mucinous neoplasm (IPMN), analyze their correlation with pathologic classification, and discuss the value of CT in the diagnosis and differential diagnosis of IPMN.
  • (1) simple main pancreatic duct (MPD) dilation type, (2) MPD dilation with pancreatic cystic lesion type, and (3) simple pancreatic cystic lesion type.
  • The 39 IPMN cases were pathologically classified as the benign group and the malignant/borderline group.
  • CT characteristics including the presence or absence of mural nodules, intrafocal partitions, focal size and the degree of MPD and common bile duct (CBD) dilation were analyzed statistically.
  • RESULTS: A correlation was found between the CT simple MPD dilation type and the pathological MPD type, between the MPD dilation with pancreatic cystic lesion type and the furcation and mixture types, and between the simple cystic lesion type and the furcation type (p<0.001).
  • The benign rate was 92% in patients without intrafocal mural nodules, and 42% in patients with intrafocal mural nodules.
  • The maximum diameter of malignant/borderline lesions was bigger than that of benign ones (p=0.016).
  • There was no significant difference in MPD and CBD diameters between the benign and malignant/borderline groups.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Mucinous / radiography. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Pancreatic Ductal / radiography. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / radiography. Tomography, X-Ray Computed / methods

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  • [Copyright] Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 19008065.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Ireland
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29. Choi JY, Lee JM, Lee MW, Kim SJ, Choi SY, Kim JY, Han JK, Choi BI: Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas. Eur Radiol; 2009 Sep;19(9):2163-70
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  • [Title] Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas.
  • The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN).
  • Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy.
  • Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D).
  • [MeSH-major] Algorithms. Carcinoma, Pancreatic Ductal / diagnosis. Cholangiopancreatography, Magnetic Resonance / methods. Image Enhancement / methods. Image Interpretation, Computer-Assisted / methods. Imaging, Three-Dimensional / methods. Pancreatic Neoplasms / diagnosis

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  • (PMID = 19381643.001).
  • [ISSN] 1432-1084
  • [Journal-full-title] European radiology
  • [ISO-abbreviation] Eur Radiol
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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30. Yamaguchi K, Nakamura M, Shirahane K, Kawamoto M, Konomi H, Ohta M, Tanaka M: Pancreatic juice cytology in IPMN of the pancreas. Pancreatology; 2005;5(4-5):416-21; discussion 421
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  • [Title] Pancreatic juice cytology in IPMN of the pancreas.
  • BACKGROUND: Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a disease ranging from adenoma to borderline (with moderate dysplasia) and further to carcinoma (noninvasive and invasive) and surgical strategy is different by the grades of dysplasia.
  • METHODS: Preoperative pancreatic juice cytology in IPMN was reviewed in 71 patients with IPMN who underwent surgical resection.
  • The sensitivity of pancreatic juice cytology in malignant IPMN was 40% (4/10).
  • In 4 patients with the 48 IPM adenomas, diagnosis of pancreatic juice cytology was class IV or V.
  • Sensitivity of pancreatic juice cytology was higher in IPMN of the main duct type with mucin hypersecretion and with mural nodules.
  • CONCLUSIONS: These findings suggest that pancreatic juice cytology in IPMN is useful especially in the main duct type with mucin hypersecretion and mural nodules.
  • When the diagnosis of pancreatic juice cytology is malignant in otherwise benign-looking IPMNs, coexistence of pancreatic carcinoma should be suspected.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Carcinoma, Papillary / diagnosis. Cytodiagnosis / methods. Pancreatic Juice / cytology. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Adenoma / classification. Adenoma / diagnosis. Aged. Female. Humans. Male. Neoplasm Staging. Retrospective Studies. Sensitivity and Specificity

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  • [Copyright] Copyright 2005 S. Karger AG, Basel and IAP.
  • (PMID = 15985766.001).
  • [ISSN] 1424-3903
  • [Journal-full-title] Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
  • [ISO-abbreviation] Pancreatology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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31. Nathan H, Cameron JL, Goodwin CR, Seth AK, Edil BH, Wolfgang CL, Pawlik TM, Schulick RD, Choti MA: Risk factors for pancreatic leak after distal pancreatectomy. Ann Surg; 2009 Aug;250(2):277-81
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  • [Title] Risk factors for pancreatic leak after distal pancreatectomy.
  • INTRODUCTION: Pancreatic leak (PL) remains a major cause of postoperative morbidity in patients undergoing pancreatic resection.
  • RESULTS: In a cohort of 704 patients undergoing primary DP, the indications for DP were benign pancreatic neoplasm (34%), malignant pancreatic neoplasm (31%), other neoplasm (15%), chronic pancreatitis (14%), pseudocyst (3%), and trauma (3%).
  • The pancreatic remnant was sutured alone in 83%, stapled alone in 5%, and both stapled and sutured in 9% of cases.
  • Ligation of the pancreatic duct was performed in 22% of cases.
  • Multivariable logistic regression analysis revealed that neither the method of closure of the pancreatic remnant (P = 0.41) nor ligation of the pancreatic duct (P > 0.05) affected the risk of clinically significant PL.
  • In contrast to some previous studies, this analysis found that surgical management of the pancreatic remnant has no effect on the incidence of clinically significant PL.
  • [MeSH-major] Pancreatectomy / adverse effects. Pancreatic Diseases / surgery. Suture Techniques / adverse effects

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  • (PMID = 19638926.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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32. Sugiyama M, Suzuki Y, Abe N, Mori T, Atomi Y: Management of intraductal papillary mucinous neoplasm of the pancreas. J Gastroenterol; 2008;43(3):181-5
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  • [Title] Management of intraductal papillary mucinous neoplasm of the pancreas.
  • Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a distinct entity characterized by papillary proliferations of mucin-producing epithelial cells with excessive mucus production and cystic dilatation of the pancreatic ducts.
  • IPMNs are classified into main duct and branch duct types, based on the site of tumor involvement.
  • The postoperative 5-year survival rate is nearly 100% for benign tumors and noninvasive carcinoma, and approximately 60% for invasive carcinoma.
  • A main duct type IPMN should be resected.
  • Surgical treatment is indicated for a branch duct IPMN with suspected malignancy (tumor diameter > or = 30 mm, mural nodules, dilated main pancreatic duct, or positive cytology) or positive symptoms.
  • IPMNs are associated with a high incidence of extrapancreatic malignancies and pancreatic ductal carcinoma.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatic Neoplasms / surgery

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  • (PMID = 18373159.001).
  • [ISSN] 0944-1174
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 37
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33. Nagaike K, Chijiiwa K, Hiyoshi M, Ohuchida J, Kataoka H: Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Int J Clin Oncol; 2007 Oct;12(5):388-91
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  • [Title] Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule.
  • Intraductal papillary mucinous neoplasm (IPMN) is an increasingly recognized entity representing a spectrum of benign and malignant neoplasms of the pancreas.
  • Preoperative distinction between benign and malignant IPMNs remains difficult.
  • Reported predictive factors for malignancy are size of the main pancreatic duct, cystic neoplasm, and mural nodule.
  • We report herein the case of a 50-year-old woman in whom a large mural nodule (30 mm) in the dilated main pancreatic duct (16 mm in diameter) was detected by ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography.
  • Because the large mural nodule and dilatation of the main pancreatic duct were also detected by endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS), the main-duct IPMN was considered to have malignant potential.
  • The resected intraductal tumor appeared polypoid with a broad stalk and comprised a proliferation of mucin-containing columnar epithelial cells with papillary structures without malignant features.
  • The size of the mural nodule and the final diagnosis in this case suggest that the introduction of a novel molecular-biological approach might be necessary for the precise preoperative diagnosis of main-duct IPMN and adequate surgical treatment.
  • [MeSH-major] Adenocarcinoma, Papillary / pathology. Carcinoma, Pancreatic Ductal / pathology. Cystadenoma, Mucinous / pathology. Pancreatic Neoplasms / pathology

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  • (PMID = 17929124.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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34. Chetty R, Serra S: Intraductal tubular adenoma (pyloric gland-type) of the pancreas: a reappraisal and possible relationship with gastric-type intraductal papillary mucinous neoplasm. Histopathology; 2009 Sep;55(3):270-6
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  • [Title] Intraductal tubular adenoma (pyloric gland-type) of the pancreas: a reappraisal and possible relationship with gastric-type intraductal papillary mucinous neoplasm.
  • AIMS: Intraductal tubular adenoma (ITA) is an uncommon intraluminal polypoid lesion that occurs in the main pancreatic duct and involves the main pancreatic duct in the region of head or body.
  • Three cases of ITA are presented, the literature reviewed and their association with intraductal papillary mucinous neoplasm (IPMN) is postulated.
  • Pancreatic intraepithelial neoplasia (PanIN) 1A and B was present in smaller ducts of all cases.
  • In addition, in the cases in this report and 50% of cases reported in the literature, an associated gastric-type IPMN was present in the same duct as the ITA or in adjacent ducts.
  • ITA could represent a localized, polypoid form of gastric-type IPMN.It is a benign lesion with no evidence of invasion and no direct tumour-related deaths.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Papillary / pathology. Adenoma / pathology. Carcinoma in Situ / pathology. Pancreatic Ducts / pathology. Pancreatic Neoplasms / pathology

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  • [CommentIn] Histopathology. 2010 Jun;56(7):968-9; author reply 969 [20636797.001]
  • (PMID = 19723141.001).
  • [ISSN] 1365-2559
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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35. Kim SC, Park KT, Lee YJ, Lee SS, Seo DW, Lee SK, Kim MH, Jang SJ, Byun JH, Han DJ: Intraductal papillary mucinous neoplasm of the pancreas: clinical characteristics and treatment outcomes of 118 consecutive patients from a single center. J Hepatobiliary Pancreat Surg; 2008;15(2):183-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraductal papillary mucinous neoplasm of the pancreas: clinical characteristics and treatment outcomes of 118 consecutive patients from a single center.
  • BACKGROUND/PURPOSE: Appropriate surgical treatment strategies based on clinicopathological findings are unavailable for intraductal papillary mucinous neoplasm (IPMN) of the pancreas.
  • We investigated the clinical features of pancreatic IPMN in a single-center database in order to design an optimal surgical strategy.
  • RESULTS: Most of the invasive carcinomas in these patients were detected as the main-duct type (88.5%).
  • The type of tumor (main-duct type vs branched-duct type), the tumor size, and the dilated duct size were significant predictive factors associated with malignancy.
  • The relative risk of malignancy was greatest at 13-mm or more ductal dilation in the main-duct type (Odds ratio, 4.1), at 35-mm or more tumor size (Odds ratio, 7.6), and for main-duct type (Odds ratio, 3.9).
  • Major pancreatic resections such as total pancreatectomy and pancreatoduodenectomy were performed in 14.5% and 69% of the patients, respectively.
  • However, significant recurrence did not occur in patients with a benign IPMN lesion which remained at the resection margin.
  • The overall postoperative survival rate at 5 years was 98.2% for benign IPMN and 65.3% for malignant IPMN.
  • CONCLUSIONS: Function-preserving strategies, based on the clinical status of the patient, are necessary in order to avoid possible severe metabolic complications following extended pancreatectomy in patients with benign IPMN because of the low recurrence rate and good prognosis of this entity, irrespective of margin status.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / diagnosis. Mucins / secretion. Pancreas / pathology

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  • (PMID = 18392712.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Mucins
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36. Uchiyama S, Chijiiwa K, Imamura N, Hiyoshi M, Ohuchida J, Nagano M, Nagaike K, Takahashi N, Akiyama Y: Adenoma of the major duodenal papilla with intraductal extension into the lower common bile duct. J Gastrointest Surg; 2008 Jun;12(6):1146-8
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  • [Title] Adenoma of the major duodenal papilla with intraductal extension into the lower common bile duct.
  • Although benign and malignant tumors of the major duodenal papilla can be detected endoscopically, definitive diagnosis of such lesions by histologic examination of biopsy specimens is sometimes difficult, especially in cases with intraductal extension into the bile duct or pancreatic duct.
  • We herein report a case of adenoma of the major duodenal papilla showing an intraductal extension into the lower common bile duct that necessitated pylorus-preserving pancreaticoduodenectomy.
  • [MeSH-major] Adenoma / pathology. Ampulla of Vater. Common Bile Duct / pathology. Duodenal Neoplasms / pathology. Neoplasm Invasiveness. Pancreaticoduodenectomy / methods

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  • (PMID = 17896165.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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37. Baiocchi GL, Portolani N, Missale G, Baronchelli C, Gheza F, Cantù M, Grazioli L, Giulini SM: Intraductal papillary mucinous neoplasm of the pancreas (IPMN): clinico-pathological correlations and surgical indications. World J Surg Oncol; 2010;8:25
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  • [Title] Intraductal papillary mucinous neoplasm of the pancreas (IPMN): clinico-pathological correlations and surgical indications.
  • BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) are increasingly recognized entities, whose management remains sometimes controversial, due to the high rate of benign lesions and on the other side to the good survival after resection of malignant ones.
  • Most patients were symptomatic (72.5%); cholangio-MRI had the best diagnostic accuracy both for the tumour nature (83.3%) and for the presence of malignancy (57.1%).
  • Thirteen patients were treated by pancreatic resection and 27 were maintained in follow-up.
  • While the main duct tumours should be resected, preserving whenever possible a portion of the gland, the secondary ducts tumours may be maintained under observation, in absence of radiological elements of suspicion such as size larger than 3 cm, or a wall greater than 3 mm or nodules or papillae in the context of the cyst.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Pancreatectomy. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Prospective Studies. Retrospective Studies. Risk Factors. Survival Rate. Treatment Outcome

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  • (PMID = 20374620.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2858722
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38. Jang JY, Kim SW, Lee SE, Yang SH, Lee KU, Lee YJ, Kim SC, Han DJ, Choi DW, Choi SH, Heo JS, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee HE, Kang GH, Lee JM: Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe? Ann Surg Oncol; 2008 Jan;15(1):199-205
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe?
  • BACKGROUND: The objectives of this study were to investigate the clinicopathological features of branch intraductal papillary mucinous neoplasm (IPMN) and to determine safe criteria for its observation.
  • Most clinicians agree that surgical resection is required to treat main duct-type IPMN because of its high malignancy rate.
  • However, no definite treatment guideline (with respect to surgery or observation) has been issued on the management of branch duct type IPMN.
  • RESULTS: Of 138 patients (mean age, 60.6 years; 87 men, 51 women), 76 underwent pancreatoduodenectomy, 39 distal pancreatectomy, 4 total pancreatectomy, and 20 limited pancreatic resection.
  • There were 112 benign cases: 47 adenoma, 63 borderline cases, and 26 malignant cases, with 9 of these being noninvasive and 17 invasive.
  • By univariate analysis, tumor size and the presence of a mural nodule were identified as meaningful predictors of malignancy.
  • By receiver operating characteristic curve analysis, a tumor size of >2 cm was found to be the most valuable predictor of malignancy.
  • When cases were classified according to tumor size and the presence of a mural nodule, the malignancy rate for a tumor </=2 cm without a mural nodule was 9.2%, for a tumor of </=2 cm plus a mural nodule was 25%, and for other conditions such as tumor >2 cm, >25%.
  • CONCLUSIONS: Many branch duct IPMNs are malignant.
  • Surgical treatment is recommended, except in cases that are strongly suspected to be benign or cases that present a high operative risk.
  • Observation is only recommended in patients with a tumor size of </=2 cm without a mural nodule.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Adenoma / surgery. Carcinoma, Pancreatic Ductal / surgery. Pancreatectomy. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 17909912.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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39. Yoon LS, Catalano OA, Fritz S, Ferrone CR, Hahn PF, Sahani DV: Another dimension in magnetic resonance cholangiopancreatography: comparison of 2- and 3-dimensional magnetic resonance cholangiopancreatography for the evaluation of intraductal papillary mucinous neoplasm of the pancreas. J Comput Assist Tomogr; 2009 May-Jun;33(3):363-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Another dimension in magnetic resonance cholangiopancreatography: comparison of 2- and 3-dimensional magnetic resonance cholangiopancreatography for the evaluation of intraductal papillary mucinous neoplasm of the pancreas.
  • PURPOSE: The purpose of this study was to compare 2-dimensional (2D) and 3D magnetic resonance cholangiopancreatography (MRCP) for image quality and diagnostic performance in the evaluation of pathologically verified intraductal papillary mucinous neoplasm (IPMN) of the pancreas.
  • Using a 5-point scale, 2 readers independently evaluated MRCPs for (1) image quality, (2) visualization of the pancreatic duct (PD), and (3) visualization of the cystic lesions.
  • Intraductal papillary mucinous neoplasm's morphological features (septa, mural nodules, and duct communication) were also graded similarly to predict benignity or malignancy.
  • A pancreatic surgeon reviewed the 21 MRCPs to determine the usefulness of 3D MRCP compared with that of 2D MRCP for surgical planning.
  • RESULTS: Of the 21 IPMNs, 11 were side-branch IPMNs and 10 were main-duct-lesions IPMNs with side-branch involvement.
  • Two-dimensional and 3D MRCPs performed similarly for predicting benign and malignant lesions, with sensitivity ranging from 50.0% to 66.7% and specificity ranging from 86.7% to 93.3%.
  • The pancreatic surgeon preferred 3D to 2D MRCP for surgical evaluation and planning in 14 of 21 cases.
  • [MeSH-major] Algorithms. Carcinoma, Pancreatic Ductal / diagnosis. Carcinoma, Papillary / diagnosis. Image Interpretation, Computer-Assisted / methods. Imaging, Three-Dimensional / methods. Pancreatic Neoplasms / diagnosis

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  • (PMID = 19478628.001).
  • [ISSN] 1532-3145
  • [Journal-full-title] Journal of computer assisted tomography
  • [ISO-abbreviation] J Comput Assist Tomogr
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] United States
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40. Ohno E, Hirooka Y, Itoh A, Ishigami M, Katano Y, Ohmiya N, Niwa Y, Goto H: Intraductal papillary mucinous neoplasms of the pancreas: differentiation of malignant and benign tumors by endoscopic ultrasound findings of mural nodules. Ann Surg; 2009 Apr;249(4):628-34
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  • [Title] Intraductal papillary mucinous neoplasms of the pancreas: differentiation of malignant and benign tumors by endoscopic ultrasound findings of mural nodules.
  • BACKGROUND AND AIM: Intraductal papillary mucinous neoplasms (IPMNs)have a wide pathologic spectrum and it is difficult to differentiate malignant from benign tumors.
  • SUBJECTS AND METHODS: In our institute, main duct type and mixed type IPMNs, branch duct type IPMNs with mural nodules, and IPMNs with coexistent invasive ductal cancer were indications for surgery.
  • Eighty-seven IPMNs (14 main duct, 25 mixed, and 48 branch duct type) were resected and CE-EUS findings were compared with pathologic findings.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Pancreatic Ductal / ultrasonography. Endosonography / methods. Neoplasm Invasiveness / pathology. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / ultrasonography
  • [MeSH-minor] Adenocarcinoma, Mucinous / diagnosis. Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Mucinous / ultrasonography. Aged. Aged, 80 and over. Analysis of Variance. Biopsy, Fine-Needle. Cohort Studies. Confidence Intervals. Contrast Media. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Logistic Models. Male. Mucous Membrane / pathology. Mucous Membrane / ultrasonography. Multivariate Analysis. Neoplasm Staging. Odds Ratio. Probability. Sensitivity and Specificity

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  • (PMID = 19300203.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media
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41. Ridolfini MP, Gourgiotis S, Alfieri S, Di Miceli D, Rotondi F, Limongelli F, Quero G, Larghi A, Cazzato MT, Martella N, Doglietto GB: [Presentation, treatment and prognosis of intraductal papillary mucinous neoplasm]. Ann Ital Chir; 2007 Jul-Aug;78(4):257-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Presentation, treatment and prognosis of intraductal papillary mucinous neoplasm].
  • [Transliterated title] Aspetti clinici, trattamento e prognosi della neoplasia papillare intraduttale mucosecernente.
  • Intraductal papillary mucinous neoplasms (IPMNs) are rare tumours rising from the pancreatic duct epithelium.
  • They are characterized by intraductal papillary growth and thick mucin secretion; mucin fills the Wirsung and/or branch pancreatic ducts and may cause ductal dilatation.
  • IPMNs are classified into three types, according to the site of involvement: main duct type, branch duct type, and combined type.
  • Most branch type IPMNs are benign, while the other two types are frequently malignant.
  • Recent advances in diagnostic imaging have led to an increased frequency of diagnosis of IPMNs, but the clinical features of them can range broadly from benign, borderline, and malignant non-invasive to invasive lesions, and their management has not yet been clearly defined.
  • Presence of a large branch type IPMN and marked dilatation of the main duct indicate the existence of adenoma.
  • Prognosis is excellent after complete resection of benign and non-invasive malignant IPMNs.
  • [MeSH-major] Adenocarcinoma, Mucinous. Carcinoma, Pancreatic Ductal. Pancreatic Neoplasms
  • [MeSH-minor] Aged. Diagnosis, Differential. Dilatation, Pathologic / etiology. Female. Humans. Male. Middle Aged. Pancreatic Ducts. Prognosis

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  • (PMID = 17990599.001).
  • [ISSN] 0003-469X
  • [Journal-full-title] Annali italiani di chirurgia
  • [ISO-abbreviation] Ann Ital Chir
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 75
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42. Yamaguchi T, Baba T, Ishihara T, Kobayashi A, Nakamura K, Tadenuma H, Ito H, Miyazaki M, Saisho H: Long-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography. Clin Gastroenterol Hepatol; 2005 Nov;3(11):1136-43
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  • [Title] Long-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography.
  • METHODS: Eighty-one patients with IPMN were periodically subjected to US (>3 years); 27 were reviewed retrospectively (12 with benign neoplasms [adenoma, borderline] and 15 with malignant tumors [carcinoma in situ, invasive cancer]) and 54 prospectively.
  • US examination was focused on the main pancreatic duct (MPD) diameter, cyst diameter, and presence or absence and height of the protruding lesion.
  • Differences between the benign and malignant groups were examined to set the criteria for surgical treatment.
  • [MeSH-major] Carcinoma, Papillary / ultrasonography. Pancreatic Neoplasms / ultrasonography
  • [MeSH-minor] Aged. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Pancreatic Ductal / ultrasonography. Female. Follow-Up Studies. Humans. Male. Middle Aged. Pancreatic Ducts / ultrasonography. Prospective Studies. Retrospective Studies

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  • (PMID = 16271346.001).
  • [ISSN] 1542-3565
  • [Journal-full-title] Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • [ISO-abbreviation] Clin. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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43. Lapkus O, Gologan O, Liu Y, Swalsky PA, Wilson MM, Finkelstein SD, Silverman JF: Determination of sequential mutation accumulation in pancreas and bile duct brushing cytology. Mod Pathol; 2006 Jul;19(7):907-13
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  • [Title] Determination of sequential mutation accumulation in pancreas and bile duct brushing cytology.
  • Neoplastic progression is characterized by clonal expansion of tumor cells associated with accumulation of mutational damage.
  • The timing of mutation acquisition could be of value in distinguishing preneoplastic conditions from early and advanced cancer as well as characterizing tumor aggressiveness and treatment response.
  • In all, 40 pancreatic duct and 21 biliary brushing cytology specimens were retrieved from the cytology database.
  • Clusters of benign, atypical and malignant cells were manually microdissected and DNA extracted.
  • The descending frequency of detectable mutational involvement in pancreatic cytology was K-ras-2 point mutation (58%), 3p25-26 and 17q21 (35%), 5q23 (33%), 1p36 (28%), followed by the remaining molecular markers.
  • The descending frequency of mutational content in bile duct cytology was 17p13, 1p36, 3p25-26, and 5q23 followed by remaining molecular markers.
  • K-ras-2 point mutation was not seen in bile duct specimens.
  • While there was overlap in the spectrum of mutational markers in pancreatic duct and biliary brushing cytology, the temporal profile was significantly different (P<0.001).
  • Pancreatic and biliary neoplasia progression involves distinct subset of accumulated defined mutations.
  • [MeSH-major] Biliary Tract Neoplasms / genetics. Cell Transformation, Neoplastic / genetics. DNA, Neoplasm / genetics. Mutation. Pancreatic Neoplasms / genetics

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  • (PMID = 16648872.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm; EC 3.6.5.2 / ras Proteins
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44. Zhang J, Wang PJ, Yuan XD, Shao CW, Zhao XH, Xu WG, Dong NX, Wang GL, Shao ZH, Huang ZL, Zhang W: [CT and pathological manifestations of intraductal papillary mucinous neoplasm of pancreas: a comparative study]. Zhonghua Yi Xue Za Zhi; 2008 Apr 8;88(14):943-7
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  • [Title] [CT and pathological manifestations of intraductal papillary mucinous neoplasm of pancreas: a comparative study].
  • OBJECTIVE: To evaluate the diagnostic value of CT in pancreas intraductal papillary mucinous neoplasm (IPMN) by analyzing its CT feature and pathological findings.
  • The CT manifestations were classified into 3 types: simple main pancreatic duct enlargement; main pancreatic duct enlargement combined with pancreatic cystic lesion; and simple pancreatic cystic lesion.
  • The correlation between the CT types and Takada pathological types (main duct type, branch type, and mixed type) was analyzed.
  • All the cases were pathologically classified into benign and malignant/boundary groups.
  • Statistical tests of the difference of CT features (mural nodule, septa, size, caliber of main pancreatic duct and common bile duct) between the 2 groups were performed.
  • RESULTS: The CT type I matched the main duct type, the CT type II mainly matched the branch type and mixed type, and the CT type III matched the branch type (P < 0.001).
  • The probability of benign lesion was 92% with no mural nodule in the lesion, while the probability of benign lesion was only 42% with mural nodule presented (P = 0.003).
  • In terms of the septa, there was no significant difference between benign and malignant lesions (P = 0.793).
  • The size of malignant/boundary lesions exceeded that of benign lesions (P = 0.016).
  • There were no significant difference in calibers of main pancreatic duct and common bile duct between the benign and malignant/ boundary groups.
  • Without considering pathological grouping the caliber of main pancreatic duct exceeded that of the common bile duct in all the cases (P = 0.02).
  • The caliber of main pancreatic duct usually exceeds that of common bile duct in IPMN.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Pancreas / radiography. Pancreatic Neoplasms / pathology

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  • (PMID = 18756963.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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45. Serikawa M, Sasaki T, Fujimoto Y, Kuwahara K, Chayama K: Management of intraductal papillary-mucinous neoplasm of the pancreas: treatment strategy based on morphologic classification. J Clin Gastroenterol; 2006 Oct;40(9):856-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of intraductal papillary-mucinous neoplasm of the pancreas: treatment strategy based on morphologic classification.
  • GOALS: The aim of this study was to examine and clarify the preoperative markers that are useful for differentiating between benign and malignant lesions of intraductal papillary-mucinous neoplasms (IPMN) of the pancreas, grouped according to morphologic classification.
  • BACKGROUND: There are various stages of pathology in IPMN, ranging from benign to malignant lesions.
  • PATIENTS AND METHODS: One hundred twenty cases of IPMN were classified morphologically into either main or branch duct types.
  • We compared the morphologic classification with histopathologic diagnosis using indicators of malignancy detected by imaging such as main duct diameter, the number and diameter of cysts, and the presence or absence of mural nodules.
  • We also examined the usefulness of pancreatic juice cytology and measurement of telomerase activity as indicators of malignancy.
  • RESULTS: Whereas a high incidence (64%) of malignant lesions was seen in main duct type IPMN, benign lesions were dominant (80.5%) in branch duct type IPMN.
  • Survival analysis showed that the prognosis was significantly worse in main duct type than in branch duct type IPMN.
  • The lesions were aggravated in all patients with main duct type who did not undergo resection, resulting in death due to progression of the pancreatic lesion.
  • The incidence of mural nodules was a useful indicator in main duct type, whereas main duct diameter and incidence of mural nodules were useful indicators in branch duct type.
  • Although pancreatic juice cytology showed a high accuracy rate with low sensitivity for determining malignancy, measurement of telomerase activity in this juice was very effective for differentiating between benign and malignant lesions.
  • CONCLUSIONS: The incidence of malignant lesions was extremely high in main duct type IPMN, indicating that surgery is required in all these patients.
  • However, to determine whether surgery is indicated in branch duct type IPMN it is necessary to obtain an appropriate image diagnosis focusing on main duct diameter and mural nodules and also to carry out cytology and measurement of telomerase activity in samples of pancreatic juice.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Female. Humans. Male. Pancreatic Juice / cytology. Prognosis. Sensitivity and Specificity. Survival Analysis. Telomerase / metabolism

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  • (PMID = 17016145.001).
  • [ISSN] 0192-0790
  • [Journal-full-title] Journal of clinical gastroenterology
  • [ISO-abbreviation] J. Clin. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.7.7.49 / Telomerase
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46. Pitman MB, Genevay M, Yaeger K, Chebib I, Turner BG, Mino-Kenudson M, Brugge WR: High-grade atypical epithelial cells in pancreatic mucinous cysts are a more accurate predictor of malignancy than "positive" cytology. Cancer Cytopathol; 2010 Dec 25;118(6):434-40
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  • [Title] High-grade atypical epithelial cells in pancreatic mucinous cysts are a more accurate predictor of malignancy than "positive" cytology.
  • Cytology slides were blindly reviewed and cells were classified as benign, AEC, or malignant.
  • On histology, neoplasms were grouped as benign (low-grade and moderate dysplasia) and malignant (high-grade dysplasia/carcinoma in situ and invasive carcinoma).
  • RESULTS: There were 92 patients with an intraductal papillary mucinous neoplasm (IPMN) and 20 with a mucinous cystic neoplasm; 39 were malignant and 73 were benign (42 with low-grade dysplasia and 31 with moderate dysplasia).
  • By using AEC as a surgical triage threshold, the sensitivity was 72%, the specificity was 85%, and the accuracy was 80%, with similar values for small (≤ 3 cm) branch duct IPMN.
  • Nine of 73 (12%) benign cysts were identified with AEC, 4 of which had moderate dysplasia.
  • CONCLUSIONS: AEC are a more accurate predictor of malignancy than "positive" cytology in aspirates of pancreatic mucinous cysts, including small branch duct IPMN.
  • [MeSH-major] Epithelial Cells / pathology. Pancreatic Cyst / pathology. Pancreatic Neoplasms / diagnosis

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  • [Copyright] Copyright © 2010 American Cancer Society.
  • (PMID = 20931638.001).
  • [ISSN] 1934-662X
  • [Journal-full-title] Cancer cytopathology
  • [ISO-abbreviation] Cancer Cytopathol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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47. Ni XG, Bai XF, Mao YL, Shao YF, Wu JX, Shan Y, Wang CF, Wang J, Tian YT, Liu Q, Xu DK, Zhao P: The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer. Eur J Surg Oncol; 2005 Mar;31(2):164-9
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  • [Title] The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.
  • AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer.
  • METHODS: Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases.
  • RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01).
  • CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242.
  • [MeSH-major] Antigens, Tumor-Associated, Carbohydrate / blood. Biomarkers, Tumor / blood. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Carcinoma, Islet Cell / blood. Carcinoma, Islet Cell / diagnosis. Pancreatic Neoplasms / blood. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Ampulla of Vater / metabolism. Ampulla of Vater / pathology. Bile Duct Neoplasms / blood. Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / surgery. Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Bilirubin / blood. Cholangiocarcinoma / blood. Cholangiocarcinoma / diagnosis. Cholangiocarcinoma / surgery. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pancreaticoduodenectomy. Prognosis. Sensitivity and Specificity. Statistics as Topic. Survival Analysis. Treatment Outcome

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  • (PMID = 15698733.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, Tumor-Associated, Carbohydrate; 0 / Biomarkers, Tumor; 0 / CA 242 antigen; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; RFM9X3LJ49 / Bilirubin
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48. Ohtsuka M, Kimura F, Shimizu H, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Mitsuhashi N, Takeuchi D, Takayashiki T, Suda K, Miyazaki M: Surgical strategy for mucin-producing bile duct tumor. J Hepatobiliary Pancreat Sci; 2010 May;17(3):236-40
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  • [Title] Surgical strategy for mucin-producing bile duct tumor.
  • Tumors with copious mucin production within the intra- or extrahepatic bile ducts have been reported as mucin-producing bile duct tumors (MPBTs).
  • Because mucin produced by these tumors causes recurrent cholangitis and obstructive jaundice, surgical resection should be indicated even if these tumors are regarded as benign.
  • In order to choose the appropriate surgical procedure, exact preoperative assessment of tumor location and cancer extension is important, especially evaluation of the extent of superficial spreading through cholangioscopic observation and biopsy.
  • In principle, MPBTs should be resected in a manner similar to that employed for other types of bile duct carcinomas.
  • That is, major hepatectomy with or without extrahepatic bile duct resection or pancreaticoduodenectomy should be chosen as the surgical procedure, and intraoperative frozen section at the stumps of the bile duct is essential.
  • All ten patients with MPBT resected at our institution according to these strategies are still alive without tumor recurrence, with a median survival of 48.0 months.
  • [MeSH-major] Bile Duct Neoplasms / surgery. Mucins / secretion
  • [MeSH-minor] Bile Ducts, Extrahepatic / metabolism. Bile Ducts, Extrahepatic / pathology. Bile Ducts, Intrahepatic / metabolism. Bile Ducts, Intrahepatic / pathology. Digestive System Surgical Procedures. Hepatectomy. Humans. Neoplasm Invasiveness. Pancreaticoduodenectomy. Prognosis

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  • (PMID = 19649559.001).
  • [ISSN] 1868-6982
  • [Journal-full-title] Journal of hepato-biliary-pancreatic sciences
  • [ISO-abbreviation] J Hepatobiliary Pancreat Sci
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Mucins
  • [Number-of-references] 20
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49. Bandyopadhyay S, Basturk O, Coban I, Thirabanjasak D, Liang H, Altinel D, Adsay NV: Isolated solitary ducts (naked ducts) in adipose tissue: a specific but underappreciated finding of pancreatic adenocarcinoma and one of the potential reasons of understaging and high recurrence rate. Am J Surg Pathol; 2009 Mar;33(3):425-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Isolated solitary ducts (naked ducts) in adipose tissue: a specific but underappreciated finding of pancreatic adenocarcinoma and one of the potential reasons of understaging and high recurrence rate.
  • The glandular units of invasive carcinoma are often well formed with well-polarized cells, appearing deceptively benign.
  • In this study, the frequency of ISDs was investigated in 105 pancreatic resections with ductal adenocarcinoma and 32 with chronic pancreatitis only.
  • ISD was detected in 50/105 (47.6%) of pancreatic resections for ductal adenocarcinoma, but not in any resections with chronic pancreatitis only (specificity 100%; sensitivity 47.6%).
  • A small subset of these units represented vascular invasion, in which the carcinoma cells epithelialized the vessel lining, transforming the vessel into a duct-like structure, virtually indistinguishable from normal ducts or PanINs.
  • ISDs were often located in histologic sections taken for the evaluation of the retroperitoneal margin and pancreatic-free surfaces where adipose tissue is more abundant.
  • In conclusion, ISD lying in adipose tissue unaccompanied by other elements, present in 47.6% of pancreatic resections when peripancreatic soft tissues away from the tumor are sampled, is a very specific finding for carcinoma that may be instrumental in the diagnosis and staging of carcinoma as well as margin evaluation.
  • [MeSH-major] Adipose Tissue / pathology. Carcinoma, Pancreatic Ductal / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Diagnosis, Differential. Humans. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Pancreatitis / pathology

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  • (PMID = 19092633.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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50. Hirono S, Tani M, Kawai M, Ina S, Nishioka R, Miyazawa M, Fujita Y, Uchiyama K, Yamaue H: Treatment strategy for intraductal papillary mucinous neoplasm of the pancreas based on malignant predictive factors. Arch Surg; 2009 Apr;144(4):345-9; discussion 349-50
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  • [Title] Treatment strategy for intraductal papillary mucinous neoplasm of the pancreas based on malignant predictive factors.
  • Identification of predictive factors for differentiating IPMC from benign IPMNs would assist in providing appropriate treatment.
  • PATIENTS: Fifty-four patients with IPMN who underwent surgery; histologic examination showed benign adenomas in 29, carcinoma in situ in 14, and invasive carcinoma in 11 patients.
  • MAIN OUTCOME MEASURES: Clinical data, preoperative imaging findings, cytologic findings, tumor markers in serum and pancreatic juice, and overall survival.
  • RESULTS: Age of 70 years or older, presence of mural nodules, mural nodule size of 5 mm or larger, and carcinoembryonic antigen (CEA) level in pancreatic juice of 110 ng/mL or higher (as obtained by preoperative endoscopic retrograde pancreatography) were predictive of a malignant IPMN by univariate analysis, and a CEA level of 110 ng/mL or higher in pancreatic juice was identified as the only independent predictive factor for the malignant entity.
  • The presence of jaundice or body weight loss, main pancreatic duct type, presence of mural nodules, mural nodule size of 5 mm or larger, and CEA level in the pancreatic juice of 110 ng/mL or higher were all predictive of invasive IPMCs by univariate analysis.
  • CONCLUSION: Measurement of the CEA level in pancreatic juice should be considered in the diagnosis of IPMC.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Prognosis. Survival Rate

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  • (PMID = 19380648.001).
  • [ISSN] 1538-3644
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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51. Park JK, Ryu JK, Lee KH, Lee JK, Yoon WJ, Lee SH, Yoo JW, Woo SM, Lee GY, Lee CH, Kim YT, Yoon YB: Quantitative analysis of NPTX2 hypermethylation is a promising molecular diagnostic marker for pancreatic cancer. Pancreas; 2007 Oct;35(3):e9-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Quantitative analysis of NPTX2 hypermethylation is a promising molecular diagnostic marker for pancreatic cancer.
  • OBJECTIVES: Percutaneous fine-needle aspiration cytology or biopsy has been used for pathological confirmation in pancreatic cancer.
  • Although endoscopic retrograde cholangiopancreatography (ERCP)-guided pancreatic duct brush cytology is less invasive, its reliability is very low.
  • Recently, aberrantly methylated genes were reported in pancreatic cancer tissue.
  • METHODS: We enrolled pathologically proven 33 pancreatic cancer patients and 22 benign pancreaticobiliary disease patients.
  • The ERCP-guided pancreatic duct brush cytology samples were obtained.
  • RESULTS: Pancreatic cancer cytology samples had statistically significant higher levels of NPTX2 methylation compared with benign diseases, and the optimal cutoff value of NPTX2 methylation was 1.2%.
  • The sensitivity was 87%, and specificity was 80%, whereas pathological examination by ERCP-guided pancreatic duct brush cytology had a sensitivity of 38%.
  • CONCLUSIONS: The quantitative analysis of NPTX2 hypermethylation may play a role in making highly sensitive and less invasive diagnosis of pancreatic cancer.
  • [MeSH-major] Biomarkers, Tumor / analysis. C-Reactive Protein / genetics. Carcinoma, Pancreatic Ductal / diagnosis. CpG Islands. DNA Methylation. DNA, Neoplasm / analysis. Neoplasm Proteins / genetics. Nerve Tissue Proteins / genetics. Pancreatic Neoplasms / diagnosis. Polymerase Chain Reaction / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cholangiopancreatography, Endoscopic Retrograde. Computer Systems. Diagnosis, Differential. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged. Pancreatic Diseases / diagnosis. Pancreatic Diseases / metabolism. Sensitivity and Specificity

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  • (PMID = 17895837.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Neoplasm; 0 / Neoplasm Proteins; 0 / Nerve Tissue Proteins; 0 / neuronal pentraxin; 9007-41-4 / C-Reactive Protein
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52. Orihara M, Kuroki M, Hiramoto K, Shohji H, Matsumura Y, Kikuchi Y, Hirakawa H, Maeda K: A case of serous cystic tumor, which recurred with severe acute pancreatitis. Nihon Shokakibyo Gakkai Zasshi; 2010 Jun;107(6):923-9
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  • [Title] A case of serous cystic tumor, which recurred with severe acute pancreatitis.
  • A 76-year-old woman with serous cystic tumor (SCT) was admitted to our hospital with abdominal pain and was given a diagnosis of severe acute pancreatitis.
  • We supposed that the growth of the SCT after hemorrhage compressed the main pancreatic duct and caused severe acute pancreatitis.
  • SCT is benign, and there are no standard treatments.
  • [MeSH-major] Cystadenoma, Serous / complications. Pancreatic Neoplasms / complications. Pancreatitis / etiology
  • [MeSH-minor] Acute Disease. Aged. Female. Humans. Neoplasm Recurrence, Local

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  • (PMID = 20530929.001).
  • [ISSN] 0446-6586
  • [Journal-full-title] Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
  • [ISO-abbreviation] Nihon Shokakibyo Gakkai Zasshi
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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53. Seicean A, Badea R, Stan-Iuga R, Mocan T, Gulei I, Pascu O: Quantitative contrast-enhanced harmonic endoscopic ultrasonography for the discrimination of solid pancreatic masses. Ultraschall Med; 2010 Dec;31(6):571-6
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  • [Title] Quantitative contrast-enhanced harmonic endoscopic ultrasonography for the discrimination of solid pancreatic masses.
  • PURPOSE: Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) for the assessment of microcirculation and the delineation of pancreatic tumors in order to characterize and stage them has only recently become available for commercial use, and few reports have been published.
  • The purpose of the study was the qualitative and quantitative digital image analysis of pancreatic adenocarcinomas using conventional endoscopic ultrasonography (EUS) and CEH-EUS and the evaluation of whether contrast medium injection modified adenocarcinoma staging and patient management.
  • MATERIALS AND METHODS: In each of 30 prospectively examined patients with suspected pancreatic solid lesions, CEH-EUS was performed using the same quantity of the contrast agent SonoVue and a low mechanical index (0.3 - 0.4), followed by EUS-FNA.
  • The histology, based on EUS-FNA or surgery and 9 months of follow-up, was: pancreatic adenocarcinoma (n = 15), pseudotumoral chronic pancreatitis (n = 12), neuroendocrine tumor (n = 1), common bile duct tumor (n = 1), lymph node metastases of gastric cancer (n = 1).
  • The size of the pancreatic mass was assessed significantly more effectively by CEH-EUS but adenocarcinoma staging was not modified.
  • CONCLUSION: The majority of cases of both pancreatic adenocarcinoma and chronic pancreatitis were hypoenhanced and visual discrimination was not possible.
  • This is the first study about CEH-EUS for the quantitative assessment of uptake after contrast injection which has shown that it can aid differentiation between benign and malignant masses but cannot replace EUS-FNA.
  • Neither tumor stage nor therapeutic management have changed after contrast medium injection during CEH-EUS.
  • [MeSH-major] Adenocarcinoma / ultrasonography. Endosonography / methods. Image Enhancement / methods. Image Processing, Computer-Assisted / methods. Pancreatic Neoplasms / ultrasonography. Tumor Burden / physiology
  • [MeSH-minor] Aged. Aged, 80 and over. Biopsy. Contrast Media / administration & dosage. Diagnosis, Differential. Female. Humans. Male. Microvessels / ultrasonography. Middle Aged. Neoplasm Staging. Neovascularization, Pathologic / ultrasonography. Pancreatitis, Chronic / pathology. Pancreatitis, Chronic / ultrasonography. Phospholipids. Prospective Studies. Sulfur Hexafluoride

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  • [Copyright] © Georg Thieme Verlag KG Stuttgart · New York.
  • (PMID = 21080306.001).
  • [ISSN] 1438-8782
  • [Journal-full-title] Ultraschall in der Medizin (Stuttgart, Germany : 1980)
  • [ISO-abbreviation] Ultraschall Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Phospholipids; 0 / contrast agent BR1; WS7LR3I1D6 / Sulfur Hexafluoride
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54. Shin SH, Han DJ, Park KT, Kim YH, Park JB, Kim SC: Validating a simple scoring system to predict malignancy and invasiveness of intraductal papillary mucinous neoplasms of the pancreas. World J Surg; 2010 Apr;34(4):776-83

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: The objective of the present study was to identify reliable preoperative factors predicting malignancy or invasiveness of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and the effectiveness of a diagnostic scoring system based on these factors.
  • METHODS: Between August 1994 and December 2007, 204 patients underwent pancreatic resection for IPMN at a single institute.
  • RESULTS: Univariate analysis revealed nine significant predictors of both malignant and invasive IPMN: age > or =60 years, history of pancreatitis, presence of mural nodule(s), diameter of main pancreatic duct (MPD) >6 mm, main duct or mixed type, total bilirubin >1.2 mg/dl, CA-19-9 >37 U/ml, tumor location in the pancreatic head, and tumor size >30 mm.
  • The 5-year survival rates of patients with benign and malignant IPMN were 95.0% and 64.0%, respectively.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology
  • [MeSH-minor] Adult. Aged. Biomarkers, Tumor / blood. Carcinoma in Situ / pathology. Chi-Square Distribution. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Staging. Predictive Value of Tests. Retrospective Studies. Risk Factors. Survival Rate. Tomography, X-Ray Computed

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  • (PMID = 20127242.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Validation Studies
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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55. Hisa T, Ohkubo H, Shiozawa S, Ishigame H, Takamatsu M, Furutake M, Nobukawa B, Suda K: Growth process of small pancreatic carcinoma: a case report with imaging observation for 22 months. World J Gastroenterol; 2008 Mar 28;14(12):1958-60
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  • [Title] Growth process of small pancreatic carcinoma: a case report with imaging observation for 22 months.
  • Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions.
  • We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up.
  • The tumor volume doubling time was 252 d.
  • [MeSH-major] Adenocarcinoma / ultrasonography. Carcinoma, Pancreatic Ductal / ultrasonography. Pancreatic Neoplasms / ultrasonography

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  • [Cites] Pancreas. 2001 May;22(4):366-9 [11345136.001]
  • [Cites] Pancreatology. 2002;2(4):407-12 [12138230.001]
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  • [Cites] Nihon Shokakibyo Gakkai Zasshi. 1994 May;91(5):1003-15 [8196194.001]
  • (PMID = 18350642.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC2700420
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56. Katayama M, Funakoshi A, Sumii T, Sanzen N, Sekiguchi K: Laminin gamma2-chain fragment circulating level increases in patients with metastatic pancreatic ductal cell adenocarcinomas. Cancer Lett; 2005 Jul 8;225(1):167-76
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  • [Title] Laminin gamma2-chain fragment circulating level increases in patients with metastatic pancreatic ductal cell adenocarcinomas.
  • The G2F level in pancreatic ductal cell adenocarcinoma patients with liver metastases was markedly elevated, but that in patients without liver metastases was not significantly elevated.
  • The G2F levels in patients with benign pancreatic tumours (pancreatic cysts and intraductal papillary mucinous tumours) were similar to that in healthy volunteers.
  • Interestingly, a significant increase in circulating G2F/G1F ratio was observed in patients with bile duct and gallbladder carcinoma, as well as in those with metastatic pancreatic ductal cell adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / secondary. Biomarkers, Tumor / blood. Carcinoma, Pancreatic Ductal / genetics. Carcinoma, Pancreatic Ductal / pathology. Cell Adhesion Molecules / blood. Laminin / blood. Liver Neoplasms / secondary. Neoplasm Metastasis. Pancreatic Neoplasms / genetics. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Aged. Case-Control Studies. Female. Gastrointestinal Neoplasms / genetics. Gastrointestinal Neoplasms / pathology. Humans. Male. Middle Aged. Neoplasm Invasiveness

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  • (PMID = 15922869.001).
  • [ISSN] 0304-3835
  • [Journal-full-title] Cancer letters
  • [ISO-abbreviation] Cancer Lett.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cell Adhesion Molecules; 0 / LAMC2 protein, human; 0 / Laminin; 0 / kalinin
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57. A-Cienfuegos J, Rotellar F, Martí-Cruchaga P, Valentí V, Zozaya G, Bueno A, Pedano N, Lozano MD, Sola JJ, Pardo F: Intraductal papillary mucinous neoplasms (IPMN) of the pancreas: clinico-pathologic results. Rev Esp Enferm Dig; 2010 May;102(5):314-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: intraductal papillary mucinous neoplasm (IPMN) shows a series of lesions which evolve from benign lesions -adenoma- to invasive carcinoma.
  • In five cases, the IPMN was combined type (both main and branch pancreatic ducts involved) in four main duct-type and branch duct-type in the another six as well.
  • CONCLUSIONS: IPMN main duct or mixed type warrants complete resection due to its incidence of invasive carcinoma or precursor lesions of malignancy as well.
  • [MeSH-major] Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / surgery. Papilloma, Intraductal / pathology. Papilloma, Intraductal / surgery

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  • (PMID = 20524759.001).
  • [ISSN] 1130-0108
  • [Journal-full-title] Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
  • [ISO-abbreviation] Rev Esp Enferm Dig
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Spain
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58. Jang JY, Kim SW, Ahn YJ, Yoon YS, Choi MG, Lee KU, Han JK, Kim WH, Lee YJ, Kim SC, Han DJ, Kim YI, Choi SH, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee KB, Kim YC, Lee KS, Kim MW, Kim HJ, Kim HJ, Park YH: Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery? Ann Surg Oncol; 2005 Feb;12(2):124-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?
  • A total of 124 patients underwent pancreatoduodenectomy, 42 underwent distal pancreatectomy, 17 underwent total pancreatectomy, and 25 underwent limited pancreatic resection.
  • There were 128 benign cases (adenoma, n = 62; borderline, n = 66) and 80 malignant cases (noninvasive, n = 29; invasive, n = 51).
  • A significant difference in 5-year survival was observed between the benign and malignant groups (92.6% vs. 65.3%; P = .006).
  • Of the six factors (age, location, duct dilatation, mural nodule, main duct type, and tumor size) that showed statistical differences by univariate analysis between the benign and malignant groups, three were significant by multivariate analysis--namely, mural nodule (P = .009), tumor size (P = .023), and a dilated duct size (P = .010).
  • CONCLUSIONS: A significant proportion of IPMTs are malignant, although the overall prognosis of IPMT is superior to that of ordinary pancreatic cancer.
  • Radical surgery is recommended for IPMT with the predictors of malignancy: mural nodule, tumor size (> or =30 mm), and dilated duct size (> or =12 mm).
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pancreatectomy. Pancreaticoduodenectomy. Preoperative Care. Prognosis. Retrospective Studies. Survival Analysis

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  • [CommentIn] Ann Surg Oncol. 2005 Feb;12(2):98-9 [15827786.001]
  • (PMID = 15827792.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
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59. Itoi T, Neuhaus H, Chen YK: Diagnostic value of image-enhanced video cholangiopancreatoscopy. Gastrointest Endosc Clin N Am; 2009 Oct;19(4):557-66
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  • Pilot studies suggest that chromoendocholangioscopy using methylene blue or cholangioscopy using AFI can distinguish benign from malignant bile duct lesions.
  • In patients with main-duct-type intraductal papillary mucinous neoplasm, peroral pancreatoscopy can be used to determine extent of tumor involvement.
  • Although many technical hurdles still need to be overcome, image-enhanced cholangiopancratoscopy appears to be a promising modality to improve diagnostic accuracy of pancreatobiliary diseases, particularly in distinguishing benign from malignant lesions.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Cholangiopancreatography, Endoscopic Retrograde / instrumentation. Image Enhancement. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Humans. Pancreatic Diseases / diagnosis

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  • (PMID = 19917461.001).
  • [ISSN] 1558-1950
  • [Journal-full-title] Gastrointestinal endoscopy clinics of North America
  • [ISO-abbreviation] Gastrointest. Endosc. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 41
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60. Jang JY: [Surgical management of intraductal papillary mucinous neoplasms]. Korean J Gastroenterol; 2008 Oct;52(4):220-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • With increasing indence and peculiar clinico-pathological features, intraductal papillary mucinous neoplasm (IPMN) of the pancreas has been a major interest in the field of pancreatology.
  • Although pathologic and clinical diversities make difficulty in decision of treatment of IPMN in some circumstances, surgical treatment is generally indicated for main duct IPMN and branch duct IPMN with suspected malignancy (tumor size > or = 30 mm, mural nodules, dilated main pancreatic duct, or positive cytology) or prominent symptoms.
  • However, invasive IPMN shows poor prognosis comparable to stage-matched pancreatic ductal adenocarcinoma.
  • Conventional pancreatic resection is recommended in case of highly suspected malignant cases, and organ preserving pancreatectomy or minimal invasive surgery could be used, especially in benign looking branch duct IPMN.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatectomy. Pancreatic Neoplasms / surgery

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  • (PMID = 19077523.001).
  • [ISSN] 1598-9992
  • [Journal-full-title] The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
  • [ISO-abbreviation] Korean J Gastroenterol
  • [Language] kor
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Korea (South)
  • [Number-of-references] 18
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61. Casadei R, Ricci C, Rega D, D'Ambra M, Pezzilli R, Tomassetti P, Campana D, Nori F, Minni F: Pancreatic endocrine tumors less than 4 cm in diameter: resect or enucleate? a single-center experience. Pancreas; 2010 Aug;39(6):825-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pancreatic endocrine tumors less than 4 cm in diameter: resect or enucleate? a single-center experience.
  • OBJECTIVE: Pancreatic endocrine tumors (PETs) are usually small, benign or low-grade malignant, and surgery should preserve the pancreatic parenchyma as much as possible.
  • METHODS: Of 82 patients having PETs, 46 with tumor less than 4 cm in diameter, without distant metastases and with R0 resection by final pathologic examination, were included in this study.
  • Enucleation was performed when the tumor did not involve the main pancreatic duct and in the absence of peripancreatic lymphadenopathy (group A); a typical resection was carried out in all other cases (group B).
  • The 2 groups were compared regarding postoperative mortality and morbidity, pancreatic fistula, postoperative hospital stay, reoperation, World Health Organization classification, TNM stage, recurrence, and long-term survival.
  • Postoperative and long-term results were similar in the 2 groups, whereas World Health Organization classification was significantly different; enucleation was performed more frequently than typical R0 resection in benign tumors (P = 0.009).
  • CONCLUSIONS: Enucleation should be reserved for patients having benign PETs less than 4 cm in diameter and far from the main pancreatic duct.
  • [MeSH-major] Neuroendocrine Tumors / surgery. Pancreatectomy / methods. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Female. Follow-Up Studies. Humans. Length of Stay. Male. Middle Aged. Neoplasm Staging. Survival Analysis. Treatment Outcome. World Health Organization

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  • (PMID = 20431423.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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62. Töx U, Hackenberg R, Stelzer A, Schulte S, Nierhoff D, Goeser T, Steffen HM: Endosonographic diagnosis of solid pancreatic tumors: a retrospective analysis from a tertiary referral center. Z Gastroenterol; 2007 Apr;45(4):307-12
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  • [Title] Endosonographic diagnosis of solid pancreatic tumors: a retrospective analysis from a tertiary referral center.
  • BACKGROUND: The sensitivity of endosonography for pancreatic tumors is good, but differentiation between malignant and benign lesions remains a challenge.
  • We, therefore, analyzed the correlation between endosonographic findings and pancreatic carcinoma in a population with a high prevalence of chronic pancreatitis.
  • RESULTS: Final diagnosis was carcinoma, chronic pancreatitis, neuroendocrine tumor and normal pancreas in 67, 65, 9, and 38 subjects (prevalence 39 %, 38 %, 5 %, 22 % respectively) After multivariate analysis, carcinoma was significantly correlated with six endosonographic criteria and age, which resulted in the following score (yes = 1, no = 0): (dilated pancreatic duct) + (vascular infiltration) + (suspicious lymph nodes) + (tumor edge with pseudopodia-like extensions) + (age > 50 years) - (increased pancreas parenchyma echogenicity) - (tumor diameter < 10 mm) + 3.
  • CONCLUSION: A simple and potentially useful score for the prediction of pancreatic cancer based on six endosonographic criteria and patient age was established.
  • [MeSH-major] Carcinoma, Neuroendocrine / ultrasonography. Endosonography. Pancreatic Neoplasms / ultrasonography
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Lymphatic Metastasis / ultrasonography. Male. Middle Aged. Neoplasm Invasiveness / ultrasonography. Pancreas / ultrasonography. Pancreatitis, Chronic / surgery. Pancreatitis, Chronic / ultrasonography. ROC Curve. Referral and Consultation. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 17427113.001).
  • [ISSN] 0044-2771
  • [Journal-full-title] Zeitschrift für Gastroenterologie
  • [ISO-abbreviation] Z Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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63. Chen CY, Lin XZ, Wu HC, Shiesh SC: The value of biliary amylase and Hepatocarcinoma-Intestine-Pancreas/Pancreatitis-associated Protein I (HIP/PAP-I) in diagnosing biliary malignancies. Clin Biochem; 2005 Jun;38(6):520-5
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  • BACKGROUND/OBJECTIVES: Elevated concentrations of Hepatocarcinoma-Intestine-Pancreas/Pancreatitis-associated Protein I (HIP/PAP-I) in pancreatic juice have been reported in patients with pancreatic adenocarcinoma and have been considered as a promising tumor marker.
  • METHODS: Bile was obtained from patients with bile duct obstruction on the day of biliary drainage.
  • The etiology of biliary obstruction included gallstones (n = 131), pancreatic cancer (n = 32), cholangiocarcinoma (n = 47), papilla Vater cancer (n = 13), hepatocellular carcinoma (n = 4) and metastatic cancer (n = 16).
  • At a cut-off value of 46 U/L, the biliary amylase distinguished patients with malignant obstruction from those with benign obstruction with a sensitivity of 66% and a specificity of 74%.
  • The divergent extent and duration of biliary obstruction caused by neoplasm and gallstones may contribute to the significant difference in the amylase activity in bile.
  • [MeSH-major] Amylases / analysis. Antigens, Neoplasm / analysis. Bile / enzymology. Bile Duct Neoplasms / diagnosis. Biomarkers, Tumor / analysis. Lectins, C-Type / analysis

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  • (PMID = 15885230.001).
  • [ISSN] 0009-9120
  • [Journal-full-title] Clinical biochemistry
  • [ISO-abbreviation] Clin. Biochem.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Lectins, C-Type; 0 / pancreatitis-associated protein; EC 3.2.1.- / Amylases
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64. Li Q, Wang JM, Liu C, Xiao BL, Lu JX, Zou SQ: Correlation of aPKC-iota and E-cadherin expression with invasion and prognosis of cholangiocarcinoma. Hepatobiliary Pancreat Dis Int; 2008 Feb;7(1):70-5
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  • BACKGROUND: The abnormal expression of atypical protein kinase C-iota (aPKC-iota) subtype and E-cadherin play important roles in tumor occurrence and progression.
  • This study was designed to investigate the correlation of expression of aPKC-iota and E-cadherin with the clinicopathological characteristics and prognosis of cholangiocarcinoma, and to analyze the molecular mechanisms of invasion and metastasis of the tumor.
  • METHODS: EnVision immunohistochemistry was used to detect the expression of aPKC-iota and E-cadherin in 9 specimens of benign bile duct tissues, 35 specimens of cholangiocarcinoma and 6 specimens of metastatic cholangiocarcinoma.
  • RESULTS: The positive expression level of aPKC-iota in cholangiocarcinoma was remarkably higher than that in benign bile duct tissues (68.6% vs. 11.1%, P=0.006), but the expression level of E-cadherin was lower in cholangiocarcinoma than in benign bile duct tissues (37.1% vs. 88.9%, P=0.016).
  • Correlation analysis revealed that the expression of aPKC-iota was positively related to tumor differentiation and invasion, whereas that of E-cadherin was entirely the contrary.
  • [MeSH-major] Bile Duct Neoplasms / metabolism. Bile Ducts, Intrahepatic / metabolism. Cadherins / metabolism. Cholangiocarcinoma / metabolism. Isoenzymes / metabolism. Protein Kinase C / metabolism
  • [MeSH-minor] Adult. Aged. Cell Polarity. Female. Humans. Immunohistochemistry. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Invasiveness. Predictive Value of Tests. Prognosis

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  • (PMID = 18234642.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Cadherins; 0 / Isoenzymes; EC 2.7.11.13 / Protein Kinase C; EC 2.7.11.13 / protein kinase C lambda
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65. Burdick JS: Intraductal papillary mucinous neoplasms. Gastrointest Endosc Clin N Am; 2008 Jul;18(3):523-33, ix-x

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  • Intraductal papillary mucinous neoplasm (IPMN) is characterized by enhanced mucus secretion.
  • It is a benign or low-grade neoplasm associated with a dilated main pancreatic duct, patulous ampullary orifice, and abundant mucus secretion.
  • Surgery is the only treatment that can cure IPMN, but the extent of pancreatic resection and the intraoperative margins remain areas of controversy.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Pancreatic Ducts / pathology. Papilloma, Intraductal / diagnosis

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  • (PMID = 18674701.001).
  • [ISSN] 1052-5157
  • [Journal-full-title] Gastrointestinal endoscopy clinics of North America
  • [ISO-abbreviation] Gastrointest. Endosc. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 39
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66. Bloomston M, Kneile J, Butterfield M, Dillhoff M, Muscarella P, Ellison EC, Melvin WS, Croce CM, Pichiorri F, Huebner K, Frankel WL: Coordinate loss of fragile gene expression in pancreatobiliary cancers: correlations among markers and clinical features. Ann Surg Oncol; 2009 Aug;16(8):2331-8
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  • Wwox has been understudied in pancreatobiliary cancers, especially in relation to other involved tumor suppressors.
  • We have assessed the status of the Fhit and Wwox proteins encoded by DNA damage susceptible chromosome fragile sites encompassed by FHIT and WWOX tumor suppressor genes.
  • METHODS: Pancreatic, gallbladder and ampullary cancers, normal pancreas, chronic pancreatitis, and benign gallbladder specimens were stained for expression of Fhit, Fhit effector protein Fdxr, Wwox, and other tumor suppressors by immunohistochemistry, and comparisons were made between benign and malignant tissue.
  • RESULTS: Fhit and Wwox were ubiquitously expressed in benign samples and significantly and coordinately reduced in pancreatic, gallbladder, and ampullary cancers.
  • In pancreatic cancers, Fdxr expression was positively correlated with Fhit and Wwox expression.
  • Neither Fhit nor Wwox expression correlated with expression of other tumor suppressors or with clinicopathologic characteristics measured.
  • CONCLUSION: Loss of Fhit and Wwox expression does not predict tumor progression or patient survival, suggesting that loss of expression of genes at the exquisitely replication stress sensitive chromosome fragile regions is an early event in the pathogenesis of cancers of the gallbladder, pancreas, and ampulla.

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  • (PMID = 19434452.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA115965; United States / NCI NIH HHS / CA / R01 CA115965-03; United States / NCI NIH HHS / CA / CA133250-01; United States / NCI NIH HHS / CA / R01 CA132453-02; United States / NCI NIH HHS / CA / CA132453; United States / NCI NIH HHS / CA / K12 CA133250-01; United States / NCI NIH HHS / CA / K12 CA133250; United States / NCI NIH HHS / CA / CA132453-02; United States / NCI NIH HHS / CA / CA115965-03; United States / NCI NIH HHS / CA / CA133250; United States / NCI NIH HHS / CA / R01 CA115965; United States / NCI NIH HHS / CA / R01 CA132453
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neoplasm Proteins; 0 / Tumor Suppressor Proteins; 0 / fragile histidine triad protein; EC 1.- / Oxidoreductases; EC 1.1.1.- / WWOX protein, human; EC 3.6.- / Acid Anhydride Hydrolases
  • [Other-IDs] NLM/ NIHMS128319; NLM/ PMC2719793
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67. Sugimoto M, Yasuda H, Koda K, Suzuki M, Yamazaki M, Tezuka T, Kosugi C, Higuchi R, Takenoue T, Yamamoto S, Watayo Y, Yagawa Y, Tsuchiya T: Virtual CO2 MDCT pancreatography: a new feasible technique for minimally invasive pancreatectomy in intraductal papillary mucinous neoplasms. Hepatogastroenterology; 2008 Jan-Feb;55(81):270-4
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  • BACKGROUND/AIMS: Less invasive pancreatic head resection, such as duodenum-preserving pancreatic head resection (DPPHR) has been introduced for the treatment of pancreatoduodenal lesions, especially for benign conditions, for reducing surgical stress and maintaining exocrine and endocrine function of the residual pancreas in consideration of postoperative quality of life (QOL).
  • METHODOLOGY: We investigated the feasibility of a new technique employing three-dimensional (3D) virtual pancreatography using multi-detector CT (MDCT) with carbon dioxide (CO2) gas as a negative contrast agent for detection of intraductal papillary mucinous neoplasm (IPMN) of the pancreas requiring minimally invasive surgery.
  • Endoscopic retrograde pancreatography (ERP) showed multiple cystic lesions in the head-uncinate process with mild dilatation in the remaining pancreatic duct.
  • For localizing diagnosis of these small and multiple pancreatic cysts, we placed an endoscopic pancreatic stent (EPS), and MDCT with injection of CO2 via EPS was examined for the virtual CO2 pancreatography, consisting of OsiriX software system employing 3D virtual anatomic reconstruction with CO2 gas as a negative contrast agent.
  • There was no residual pancreatic cyst and tumor after surgery.
  • The resected tumor was diagnosed as branch duct type intraductal papillary mucinous adenocarcinoma.
  • According to our minimally invasive DPPHR obtained by virtual CO2 pancreatography, the pancreatic endocrine and exocrine functions of this patient were maintained at almost the same levels as those in his preoperative status.
  • CONCLUSIONS: Our new technique of virtual CO2 MDCT pancreatography is a feasible procedure for preservation of the remnant pancreatic function.
  • This is the first report of virtual CO2 pancreatography providing minimally invasive pancreatic surgery.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Adenocarcinoma, Papillary / surgery. Carcinoma, Pancreatic Ductal / radiography. Carcinoma, Pancreatic Ductal / surgery. Pancreatectomy / methods. Pancreatic Neoplasms / radiography. Pancreatic Neoplasms / surgery. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Carbon Dioxide. Cholangiopancreatography, Endoscopic Retrograde. Dilatation, Pathologic. Feasibility Studies. Humans. Pancreatic Ducts / pathology

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  • (PMID = 18507123.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 142M471B3J / Carbon Dioxide
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68. Somorácz A, Tátrai P, Horváth G, Kiss A, Kupcsulik P, Kovalszky I, Schaff Z: Agrin immunohistochemistry facilitates the determination of primary versus metastatic origin of liver carcinomas. Hum Pathol; 2010 Sep;41(9):1310-9
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  • In addition, we proved the utility of agrin immumohistochemistry in discriminating between HCCs and benign parenchymal lesions.
  • Immunohistochemistry for agrin was performed on 25 HCC, 16 intrahepatic CCC, 20 colorectal cancer metastasis (CRCm), and 18 pancreatic ductal carcinoma metastasis (PDCm) samples and evaluated with both quantitative and qualitative methods.
  • Regardless of tumor grade, agrin immunostaining was strong in the microvessels of HCCs.
  • As opposed to HCC, agrin immunostaining was faint or nearly absent from the CD34-positive microvessels of CCC, CRCm, and PDCm; rather, it was detected in the basement membranes surrounding tumor cell pseudoglandules.
  • [MeSH-minor] Adult. Aged. Antigens, CD34 / metabolism. Bile Duct Neoplasms / genetics. Bile Duct Neoplasms / metabolism. Bile Duct Neoplasms / pathology. Bile Ducts, Intrahepatic / metabolism. Bile Ducts, Intrahepatic / pathology. Biomarkers, Tumor / genetics. Biomarkers, Tumor / metabolism. Carcinoma, Pancreatic Ductal / genetics. Carcinoma, Pancreatic Ductal / metabolism. Carcinoma, Pancreatic Ductal / secondary. Cholangiocarcinoma / genetics. Cholangiocarcinoma / metabolism. Cholangiocarcinoma / pathology. DNA, Neoplasm / analysis. Diagnosis, Differential. Endothelium, Vascular / metabolism. Endothelium, Vascular / pathology. Female. Gene Expression Regulation, Neoplastic. Hepatectomy. Humans. Male. Microvessels / metabolism. Microvessels / pathology. Middle Aged. Pancreatic Neoplasms / genetics. Pancreatic Neoplasms / metabolism. Pancreatic Neoplasms / pathology. RNA, Messenger / metabolism. Young Adult

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20471664.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Agrin; 0 / Antigens, CD34; 0 / Biomarkers, Tumor; 0 / DNA, Neoplasm; 0 / RNA, Messenger
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69. Geraci G, Pisello F, Arnone E, Modica G, Sciumè C: Endoscopic cytology in biliary strictures. Personal experience. G Chir; 2008 Oct;29(10):403-6
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  • INTRODUCTION: The differential diagnosis between malignant and benign biliary strictures is the cornerstone of the management of jaundiced patients.
  • We founded hilar stricture in 21 patients (31.3%), middle third the common duct stricture in 17 (25.3%), and lower third stricture in 28 patients (41.4%).
  • The presence of neoplasm in the pancreato-biliary tract was excluded (absence of malignant cells) in 25 of 40 diagnostic exams (62.5%).
  • During follow-up only 7 of these 25 patients resulted in having a benign disease (true negatives 28%) while the remaining 18 cases were diagnosed with malignant neoplasm of the pancreato-biliary tract (false negatives 72%).
  • Nine of 14 with positive cytology for carcinoma were diagnosed with cholangiocarcinoma (65%), 4 with pancreatic (28%) and 1 with ampullary carcinoma.
  • Of 25 non-diagnostic samples, 5 (20%) resulted as benign, 20 (80%) as malignant.
  • [MeSH-major] Bile / cytology. Bile Duct Neoplasms / pathology. Cholangiocarcinoma / pathology. Cholangiopancreatography, Endoscopic Retrograde. Jaundice, Obstructive / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Bile Duct Diseases / pathology. Biopsy, Needle. Chi-Square Distribution. Constriction, Pathologic / diagnosis. Diagnosis, Differential. Drainage / instrumentation. Drainage / methods. Female. Follow-Up Studies. Humans. Male. Middle Aged. Predictive Value of Tests. Retrospective Studies. Sensitivity and Specificity. Stents. Treatment Outcome

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  • (PMID = 18947461.001).
  • [ISSN] 0391-9005
  • [Journal-full-title] Il Giornale di chirurgia
  • [ISO-abbreviation] G Chir
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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70. Yang AD, Melstrom LG, Bentrem DJ, Ujiki MB, Wayne JD, Strouch M, Bell RH, Rao SM, Talamonti MS: Outcomes after pancreatectomy for intraductal papillary mucinous neoplasms of the pancreas: an institutional experience. Surgery; 2007 Oct;142(4):529-34; discussion 534-7
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  • PURPOSE: To evaluate the experience with pancreatectomy for intraductal papillary mucinous neoplasm (IPMN) at a single academic institution.
  • METHODS: A prospective pancreatic database was reviewed and identified 43 patients with IPMN who were managed operatively.
  • RESULTS: IPMN was diagnosed in 21% of patients who underwent pancreatic resection for solid or cystic mass lesions.
  • Overall, 23 patients (53%) had lesions with main duct involvement.
  • With a mean follow-up of 17 months, the 5-year disease-specific survival for patients with main duct involvement was 67%.
  • The 5-year disease-specific survival for patients with benign lesions was 100%, and 61% for patients with malignant lesions (P = .02).
  • The presence of symptoms, increased CA 19-9, and tumor size were not predictive of malignancy.
  • Main duct involvement was also associated with malignancy (P < .02).
  • CONCLUSIONS: Cancer is found in 65% of patients with IMPN involving the main duct.
  • Based on our data, patients with symptomatic, main duct involvement, especially those with an increased serum bilirubin, should be offered resection.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatectomy / statistics & numerical data. Pancreatic Neoplasms / surgery

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  • (PMID = 17950345.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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71. Ishida M, Egawa S, Aoki T, Sakata N, Mikami Y, Motoi F, Abe T, Fukuyama S, Sunamura M, Unno M, Moriya T, Horii A, Furukawa T: Characteristic clinicopathological features of the types of intraductal papillary-mucinous neoplasms of the pancreas. Pancreas; 2007 Nov;35(4):348-52
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  • OBJECTIVES: Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas encompasses a spectrum of neoplasms with both morphological and immunohistochemical variations of mucin glycoproteins.
  • Characteristically, the gastric-type IPMNs were likely to be diagnosed as benign, to be confined to branch ducts, and to have fair prognoses.
  • On the other hand, the intestinal-type IPMNs were likely to be diagnosed as malignant, occupy the main duct, and have poor prognoses.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma, Mucinous / pathology. Adenoma / pathology. Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Pancreatic Ducts / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Aged. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Mucin 5AC. Mucin-1 / analysis. Mucin-2. Mucins / analysis. Neoplasm Invasiveness. Prognosis. Retrospective Studies

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  • (PMID = 18090241.001).
  • [ISSN] 1536-4828
  • [Journal-full-title] Pancreas
  • [ISO-abbreviation] Pancreas
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / MUC1 protein, human; 0 / MUC2 protein, human; 0 / MUC5AC protein, human; 0 / Mucin 5AC; 0 / Mucin-1; 0 / Mucin-2; 0 / Mucins
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72. Zhou JP, Dong M, Zhang Y, Kong FM, Guo KJ, Tian YL: Giant mucinous biliary cystadenoma: a case report. Hepatobiliary Pancreat Dis Int; 2007 Feb;6(1):101-3
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  • BACKGROUND: Biliary cystadenoma is a very rare cystic neoplasm of the liver.
  • Gross examination showed that the tumor almost occupied.
  • Pathologically, additional lobulated spaces were seen in the tumor with a lot of mucusa.
  • The interior wall was lined with bile duct tissue, indicating a benign mucinous biliary cystadenoma.
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Duct Neoplasms / surgery. Bile Ducts, Intrahepatic. Cystadenoma, Mucinous / diagnosis. Cystadenoma, Mucinous / surgery

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  • (PMID = 17287176.001).
  • [ISSN] 1499-3872
  • [Journal-full-title] Hepatobiliary & pancreatic diseases international : HBPD INT
  • [ISO-abbreviation] HBPD INT
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
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73. Espinel Diez J, Vivas Alegre S, Muñoz Núñez F, Domínguez Carbajo A, Villanueva Pavón R, Jorquera Plaza F, Olcoz Goñi JL: [Needle-knife sphincterotomy for biliary access: a prospective study]. Gastroenterol Hepatol; 2005 Aug-Sep;28(7):369-74

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The aim of this study was to analyze the results of NNS in patients with an inaccessible common bile duct (difficult cannulation) using standard techniques in endoscopic retrograde cholangiopancreatography and the factors associated with the success of this procedure and complications.
  • MATERIAL AND METHODS: We performed a prospective study of 72 patients who underwent NKS performed by the same endoscopist (J.E.) because of difficult cannulation of the common bile duct between January 1998 and December 2004.
  • A total of 77.7% of the patients underwent prior implantation of a pancreatic prosthesis (NKS-PP).
  • The final diagnosis was: choledocholithiasis (31.9%), cancer of the pancreas (16.6%), cholangiocarcinoma (13.8%), benign stenosis (8.3%), dysfunction of the sphincter of Oddi (6.9%), normal (6.9%), and miscellaneous (13.8%).
  • The use of a pancreatic prosthesis was related to a higher success rate and significantly fewer complications (p = 0.03).
  • CONCLUSIONS: NKS-PP can be a safe procedure in patients with difficult cannulation of the common bile duct.
  • The presence of biliopancreatic neoplasm is a risk factor for failure to achieve biliary access compared with other diagnoses.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Ampulla of Vater / injuries. Cholangiocarcinoma / diagnosis. Cholangitis / etiology. Choledocholithiasis / diagnosis. Common Bile Duct Neoplasms / diagnosis. Constriction, Pathologic. Female. Hemorrhage / etiology. Humans. Liver Neoplasms / diagnosis. Male. Middle Aged. Pancreatic Neoplasms / diagnosis. Pancreatitis / etiology. Postoperative Complications / etiology. Prospective Studies. Sphincter of Oddi / pathology. Stents

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  • (PMID = 16137469.001).
  • [ISSN] 0210-5705
  • [Journal-full-title] Gastroenterología y hepatología
  • [ISO-abbreviation] Gastroenterol Hepatol
  • [Language] spa
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 40
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74. Salla C, Chatzipantelis P, Konstantinou P, Karoumpalis I, Sakellariou S, Pantazopoulou A, Manika Z: Endoscopic ultrasound-guided fine-needle aspiration cytology in the diagnosis of intraductal papillary mucinous neoplasms of the pancreas. A study of 8 cases. JOP; 2007;8(6):715-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • CONTEXT: Intraductal papillary mucinous neoplasm (IPMN) is an increasingly recognized neoplasm of the pancreas, accounting for 5% of pancreatic neoplasms, it is considered difficult to diagnose by fine-needle aspiration (FNA) cytology.
  • In all cases, the hypoechoic mass had a distinctive distribution, involving the main pancreatic duct and/or the associated large branch ducts while intraductal nodules or multiple cysts were detected.
  • Two cases were diagnosed as benign IPMN and, in 3 cases, the biological behavior was not easy to determine by cytology alone (histologically diagnosed as borderline).
  • The histological diagnosis confirmed the FNA cytology diagnosis: 3 malignant IPMNs, 2 benign IPMNs and 3 borderline IPMNs.
  • Mucin 1 (MUC-1) was positive in 2 cases of malignant IPMN (histologically classified as null type ad intestinal type), mucin 2 (MUC-2) was positive in 3 cases (2 malignant both of the intestinal type, and 1 benign of the intestinal type I) and c-erbB2 was positive in 3 cases (2 benign - null and intestinal type - and 1 malignant null type).
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Papillary / diagnosis. Adenocarcinoma, Papillary / pathology. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / pathology

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  • (PMID = 17993724.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Mucins; EC 2.7.10.1 / Receptor, ErbB-2
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75. Qin X, Liu F: The clinicopathologic features of intraductal papillary mucinous neoplasms of the pancreas. Front Med China; 2007 May;1(2):121-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Since first described in 1982, intraductal papillary mucinous neoplasm (IPMN) has been the preferred term to describe the proliferation of the pancreatic ductal epithelium.
  • It is totally different from pancreatic carcinoma in epidemiology, histology, pathology and prognosis.
  • According to the site of involvement, IPMNs are classified into three categories, i.e. main duct type, branch duct type, and combined type.
  • Most branch duct IPMNs are benign, whereas the other two types are often malignant.
  • A large branch duct IPMN and marked dilation of the main pancreatic duct indicate the presence of adenoma at least.
  • The prognosis is more favorable after complete resection of benign and non-invasive malignant IPMNs.
  • On the other hand, asymptomatic branch duct IPMNs without mural nodules can be observed without the need for resection for a considerable period of time.

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  • (PMID = 24557662.001).
  • [ISSN] 1673-7342
  • [Journal-full-title] Frontiers of medicine in China
  • [ISO-abbreviation] Front Med China
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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76. Ligato S, Zhao H, Mandich D, Cartun RW: KOC (K homology domain containing protein overexpressed in cancer) and S100A4-protein immunoreactivity improves the diagnostic sensitivity of biliary brushing cytology for diagnosing pancreaticobiliary malignancies. Diagn Cytopathol; 2008 Aug;36(8):561-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In this study we applied KOC and S100A4 protein immunocytochemistry to assess their potential use as adjunct markers in differentiating benign from malignant cells, and improve the diagnostic sensitivity of this method for pancreatobiliary malignancies.
  • (1) benign/atypical favor reactive (20 cases), (2) atypical/not diagnostic of malignancy (3 cases), and (3) suspicious for malignancy/malignant (21 cases).
  • [MeSH-major] Bile Duct Neoplasms / diagnosis. Bile Ducts / pathology. Neoplasm Proteins / immunology. Pancreatic Neoplasms / diagnosis. RNA-Binding Proteins / immunology. S100 Proteins / immunology

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  • (PMID = 18618724.001).
  • [ISSN] 1097-0339
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / IMP3 protein, human; 0 / Neoplasm Proteins; 0 / RNA-Binding Proteins; 0 / S100 Proteins; 142662-27-9 / S100A4 protein, human
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77. Kawamoto S, Siegelman SS, Hruban RH, Fishman EK: Lymphoplasmacytic sclerosing pancreatitis (autoimmune pancreatitis): evaluation with multidetector CT. Radiographics; 2008 Jan-Feb;28(1):157-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Lymphoplasmacytic sclerosing pancreatitis is a form of chronic pancreatitis characterized by a mixed inflammatory infiltrate that centers on the pancreatic ducts.
  • It is a cause of benign pancreatic disease that can clinically mimic pancreatic cancer.
  • Patients with lymphoplasmacytic sclerosing pancreatitis are often referred for computed tomography (CT) when they are suspected of having a pancreatic or biliary neoplasm; therefore, it is important to search for potential findings suggestive of lymphoplasmacytic sclerosing pancreatitis when typical findings of a pancreatic or biliary neoplasm are not found.
  • Typical CT findings include diffuse or focal enlargement of the pancreas without dilatation of the main pancreatic duct.
  • Thickening and contrast enhancement of the wall of the common bile duct and gallbladder may reflect inflammatory infiltrate and fibrosis associated with lymphoplasmacytic sclerosing pancreatitis.
  • There are several features seen at CT that may help to differentiate lymphoplasmacytic sclerosing pancreatitis from pancreatic cancer, such as diffuse enlargement of the pancreas with minimal peripancreatic stranding in patients with obstructive jaundice, an absence of significant pancreatic atrophy, and an absence of significant main pancreatic duct dilatation.

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  • (PMID = 18203936.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 49
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78. Shin LK, Brant-Zawadzki G, Kamaya A, Jeffrey RB: Intraoperative ultrasound of the pancreas. Ultrasound Q; 2009 Mar;25(1):39-48; quiz 48
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • This pictorial essay will review common benign and malignant pancreatic processes including the following: pancreatic ductal adenocarcinoma, pancreatitis, endocrine tumors, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, serous cystadenoma, and solid pseudopapillary tumor.
  • (1) identification of insulinoma(s) which are not detectable preoperatively, (2) identification of the pancreatic duct to determine dissection planes for chronic pancreatitis surgery (eg, Puestow procedure) and for tumor resection, and (3) staging purposes for malignant disease.
  • [MeSH-major] Pancreatectomy / methods. Pancreatic Diseases / surgery. Pancreatic Diseases / ultrasonography. Surgery, Computer-Assisted / methods. Ultrasonography, Interventional / methods

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  • (PMID = 19276960.001).
  • [ISSN] 1536-0253
  • [Journal-full-title] Ultrasound quarterly
  • [ISO-abbreviation] Ultrasound Q
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 49
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79. Kitagawa H, Okabayashi T, Nishimori I, Kobayashi M, Sugimoto T, Akimori T, Kohsaki T, Miyaji E, Onishi S, Araki K: Rapid growth of mucinous cystic adenoma of the pancreas following pregnancy. Int J Gastrointest Cancer; 2006;37(1):45-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • At 8 mo postpartum, she became aware of an upper abdominal tumor.
  • Endoscopic retrograde pancreatography showed no connection between the main pancreatic duct and the cystic lesion.
  • The patient underwent tumor resection at 11 mo postpartum.
  • Pathological examination of the tumor revealed mucin-producing columnar epithelial cells lining the cystic wall with ovarian-type stromal tissue and no findings indicative of malignancy, giving a diagnosis of mucinous cystic adenoma of the pancreas.
  • Postpartum rapid growth of a benign mucinous cystic neoplasm might be linked to the production of female sex hormones during lactation.
  • [MeSH-major] Adenoma / pathology. Cystadenocarcinoma, Mucinous / pathology. Pancreatic Neoplasms / pathology. Pregnancy Complications, Neoplastic / pathology

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  • (PMID = 17290080.001).
  • [ISSN] 1537-3649
  • [Journal-full-title] International journal of gastrointestinal cancer
  • [ISO-abbreviation] Int J Gastrointest Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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80. Barakat O, Rodriguez GC, Raijman I, Allison PM, Nieto J, Ozaki CF, Wood RP, Engler DA: Clinical value of plasma hepatocyte growth factor measurement for the diagnosis of periampullary cancer and prognosis after pancreaticoduodenectomy. J Surg Oncol; 2010 Dec 1;102(7):816-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODS: Of the patients enrolled in this pilot study (n = 118), 57 had PAC, 21 had benign pancreatic tumor (BPT), 20 had chronic pancreatitis (CP), and 20 were healthy controls.
  • CONCLUSIONS: Plasma HGF level discriminates well between PAC and other, benign diseases.
  • Therefore, HGF measurement could be a useful addition to the existing array of diagnostic tools for PAC pancreatic cancer.
  • [MeSH-major] Ampulla of Vater / pathology. Biomarkers, Tumor / blood. Common Bile Duct Neoplasms / blood. Hepatocyte Growth Factor / blood. Pancreaticoduodenectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Enzyme-Linked Immunosorbent Assay. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Pilot Projects. Postoperative Period. Prognosis. Retrospective Studies. Survival Rate. Young Adult

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  • [Copyright] 2010 Wiley-Liss, Inc.
  • (PMID = 20812348.001).
  • [ISSN] 1096-9098
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 67256-21-7 / Hepatocyte Growth Factor
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81. Bassi C, Sarr MG, Lillemoe KD, Reber HA: Natural history of intraductal papillary mucinous neoplasms (IPMN): current evidence and implications for management. J Gastrointest Surg; 2008 Apr;12(4):645-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Intraductal papillary mucinous neoplasms (IPMNs) show varying degrees of dysplasia throughout the neoplasm that can range from adenoma to invasive carcinoma, with dysplastic changes of borderline neoplasms and carcinoma in situ in between.
  • Clues to the natural history of IPMNs can be gained by using several methods to examine the articles: (a) to verify different prognoses between main and side branch duct subtypes;.
  • (b) to compare the average age of patients with benign vs. malignant IPMNs;.
  • (1) Branch-duct IPMNs are less aggressive than main-duct IPMNs. (2) Malignancy is more common in older patients. (3) Malignancy (invasive or carcinoma in situ) is found in about 70% of resected main-duct IPMNs. (4) After resection of noninvasive IPMNs (branch- and main-duct varieties), recurrence is rare (<8%). (5) After resection of invasive IPMN, recurrence occurs in 50-65% of patients.
  • [MeSH-major] Adenocarcinoma, Mucinous. Adenocarcinoma, Papillary. Carcinoma, Pancreatic Ductal. Pancreatic Neoplasms

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  • (PMID = 18097728.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 38
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82. Fan F, Lai EC, Xie F, Yang JM, Xu F, Kan T, Shen RX, Yang XY, Lau Wan Y, Wu MC: Intraductal papillary mucinous neoplasms of the pancreas--predictors of malignancy. Hepatogastroenterology; 2010 May-Jun;57(99-100):635-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODOLOGY: Forty patients who underwent pancreatic resection for IPMN at a single tertiary center between January 1996 and March 2008 were retrospectively analyzed.
  • Patients with benign IPMN had 1-, 3-, and 5-year overall survival rates of 100%, 94.1%, and 88.2%, respectively and 1-, 3-, and 5-year disease-free survival rates of 100%, 94.1%, and 88.2%, respectively.
  • Abdominal pain, jaundice, main-duct or mixed type, tumor size, mural nodule and size of mural nodule, were predictive of malignant IPMN by univariate analysis, and size of mural nodule was identified as the only independent predictive factor for malignancy.
  • [MeSH-major] Adenocarcinoma, Mucinous / surgery. Carcinoma, Pancreatic Ductal / surgery. Carcinoma, Papillary / surgery. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Retrospective Studies

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  • (PMID = 20698241.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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83. Katsinelos P, Paroutoglou G, Kountouras J, Beltsis A, Papaziogas B, Mimidis K, Zavos C, Dimiropoulos S: Safety and long-term follow-up of endoscopic snare excision of ampullary adenomas. Surg Endosc; 2006 Apr;20(4):608-13

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • If there was no common bile and main pancreatic duct invasion and the appearance suggested a benign lesion, biductal sphincterotomy onto normal duodenal tissue was performed.
  • At the discretion of the endoscopist, a biliary or pancreatic stent was inserted as a prophylactic procedure immediately after excision.
  • Pancreatic and biliary stents were placed in four and nine patients, respectively.
  • [MeSH-major] Adenoma / surgery. Ampulla of Vater. Common Bile Duct Neoplasms / surgery. Endoscopy, Digestive System / methods
  • [MeSH-minor] Adult. Aged. Cholangiopancreatography, Endoscopic Retrograde. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Retrospective Studies. Stents. Treatment Outcome

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  • (PMID = 16508819.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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84. Scheiman JM: Management of cystic lesions of the pancreas. J Gastrointest Surg; 2008 Mar;12(3):405-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Pancreatic cystic lesions are being increasingly identified.
  • Magnetic resonance imaging has the potential added advantage of determining communication between the cyst and pancreatic duct.
  • In the absence of a history of pancreatitis, pseudocyst is quite unlikely, and the concern of a cystic neoplasm is paramount.
  • For those patients with benign-appearing lesions, such as classic appearance of a serous cystadenoma, observation alone seems appropriate.
  • [MeSH-major] Diagnostic Imaging. Pancreatic Cyst / diagnosis. Pancreatic Cyst / therapy. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Algorithms. Biopsy, Fine-Needle. Cystadenoma, Serous. Diagnosis, Differential. Endosonography. Magnetic Resonance Imaging. Pancreatic Pseudocyst / radiography. Pancreatic Pseudocyst / ultrasonography

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  • (PMID = 17957437.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 12
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85. Bussom S, Saif MW: Intraductal papillary mucinous neoplasia (IPMN). Highlights from the "2010 ASCO Gastrointestinal Cancers Symposium". Orlando, FL, USA. January 22-24, 2010. JOP; 2010;11(2):131-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraductal papillary mucinous neoplasia (IPMN). Highlights from the "2010 ASCO Gastrointestinal Cancers Symposium". Orlando, FL, USA. January 22-24, 2010.
  • IPMN is a disease of the ductal epithelium and represent a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important.
  • Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential.
  • Growing controversy revolves around issues of natural history, management of small-branch-duct lesions, ability to predict malignancy and/or progression, and surveillance strategies.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / diagnosis. Carcinoma, Pancreatic Ductal / pathology. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma, Mucinous / classification. Adenocarcinoma, Mucinous / diagnosis. Adenocarcinoma, Mucinous / pathology. Carcinoma, Papillary / classification. Carcinoma, Papillary / diagnosis. Carcinoma, Papillary / pathology. Congresses as Topic. Cyst Fluid / chemistry. Cytokines / analysis. Early Detection of Cancer / methods. Enzyme-Linked Immunosorbent Assay. Gastrointestinal Neoplasms / diagnosis. Humans. Models, Biological. Neoplasm Staging / methods

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  • (PMID = 20208320.001).
  • [ISSN] 1590-8577
  • [Journal-full-title] JOP : Journal of the pancreas
  • [ISO-abbreviation] JOP
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Cytokines
  • [Number-of-references] 26
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86. Sperti C, Bissoli S, Pasquali C, Frison L, Liessi G, Chierichetti F, Pedrazzoli S: 18-fluorodeoxyglucose positron emission tomography enhances computed tomography diagnosis of malignant intraductal papillary mucinous neoplasms of the pancreas. Ann Surg; 2007 Dec;246(6):932-7; discussion 937-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To assess the reliability of 18-fluorodeoxyglucose positron emission tomography (18-FDG PET) in distinguishing benign from malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas and its contribution to surgical decision making.
  • SUMMARY BACKGROUND DATA: Pancreatic IPMNs are increasingly recognized, often as incidental findings, especially in people over age 70 and 80.
  • Computed tomography (CT) and magnetic resonance (MR) are unreliable in discriminating a benign from a malignant neoplasm.
  • 18-FDG PET as imaging procedure based on the increased glucose uptake by tumor cells has been suggested for diagnosis and staging of pancreatic cancer.
  • The validation of the diagnosis was made by a surgical procedure (n = 44), a percutaneous biopsy (n = 2), main duct cytology (n = 1), or follow-up (n = 17).
  • Forty-two patients underwent pancreatic resection, 2 palliative surgery, and 20 did not undergo surgery.
  • An adenoma was diagnosed in 13 patients, a borderline tumor in 8, a carcinoma in situ in 5, and an invasive cancer in 21; in 17 patients a tumor sampling was not performed and therefore the histology remained undetermined.
  • CONCLUSIONS: 18-FDG PET is more accurate than conventional imaging techniques (CT and MR) in distinguishing benign from malignant (invasive and noninvasive) IPMNs.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Adenocarcinoma, Papillary / diagnosis. Carcinoma, Pancreatic Ductal / diagnosis. Fluorodeoxyglucose F18. Pancreatic Neoplasms / diagnosis. Tomography, Emission-Computed / methods. Tomography, X-Ray Computed / methods

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  • (PMID = 18043094.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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87. Crippa S, Bassi C, Warshaw AL, Falconi M, Partelli S, Thayer SP, Pederzoli P, Fernández-del Castillo C: Middle pancreatectomy: indications, short- and long-term operative outcomes. Ann Surg; 2007 Jul;246(1):69-76
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The most common indications were neuroendocrine neoplasms, serous cystadenoma, and branch-duct IPMNs.
  • The 2 groups showed no differences in overall morbidity, abdominal complications, overall pancreatic fistula, and grade B/C pancreatic fistula rate (17% in MP and 13% in ELP), but the mean hospital-stay was longer for MP patients (P = 0.005).
  • CONCLUSIONS: MP is a safe and effective procedure for treatment of benign and low-grade malignant neoplasms of the mid pancreas and is associated with a low risk of development of exocrine and endocrine insufficiency.
  • MP should be avoided in patients affected by main-duct IPMN.
  • [MeSH-major] Pancreatectomy / methods. Pancreatic Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Cohort Studies. Female. Follow-Up Studies. Humans. Incidence. Length of Stay. Male. Massachusetts / epidemiology. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Postoperative Complications / epidemiology. Retrospective Studies. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 17592293.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1899210
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88. Sperti C, Pasquali C, Fiore V, Bissoli S, Chierichetti F, Liessi G, Pedrazzoli S: Clinical usefulness of 18-fluorodeoxyglucose positron emission tomography in the management of patients with nonpancreatic periampullary neoplasms. Am J Surg; 2006 Jun;191(6):743-8
MedlinePlus Health Information. consumer health - Pancreatic Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: 18-Fluorodeoxyglucose positron emission tomography (18-FDG PET) has been investigated for the diagnosis and staging of gastrointestinal malignancies including pancreatic adenocarcinoma.
  • RESULTS: Between January 1998 and December 2003, 14 ampullary, 7 bile duct, and 4 duodenal tumors were included in the study.
  • PET showed increased focal uptake in 22 patients (88%): 11 of 14 (79%) ampullary tumors, and 100% of bile duct and duodenal tumors.
  • It may be useful to differentiate benign or borderline lesions from invasive tumors when no mass has been identified by traditional imaging.
  • [MeSH-major] Ampulla of Vater / radionuclide imaging. Bile Duct Neoplasms / radionuclide imaging. Duodenal Neoplasms / radionuclide imaging. Pancreatic Neoplasms / radionuclide imaging. Positron-Emission Tomography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Fluorodeoxyglucose F18. Humans. Laparotomy / methods. Male. Middle Aged. Neoplasm Staging. Risk Assessment. Sensitivity and Specificity

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  • (PMID = 16720142.001).
  • [ISSN] 0002-9610
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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89. Kobayashi G, Fujita N, Noda Y, Ito K, Horaguchi J, Takasawa O, Akaishi S, Tsuchiya T, Kobari M: Mode of progression of intraductal papillary-mucinous tumor of the pancreas: analysis of patients with follow-up by EUS. J Gastroenterol; 2005 Jul;40(7):744-51
MedlinePlus Health Information. consumer health - Pancreatic Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mode of progression of intraductal papillary-mucinous tumor of the pancreas: analysis of patients with follow-up by EUS.
  • BACKGROUND: We investigated the mode of progression of intraductal papillary-mucinous neoplasm of the pancreas (IPMN) in patients who underwent follow-up in order to elucidate the characteristics of malignancy and to establish an effective treatment strategy.
  • METHODS: Fifty-one patients with IPMN (branch-duct type, 47; main-duct type, 4) who had undergone follow-up study by endoscopic ultrasonography (EUS) were included (mean follow-up duration, 41.0+/-32.3 months; average number of EUS examinations performed during follow-up, 4.4).
  • RESULTS: Of the patients with the branch-duct type, only 2% showed enlargement of the dilated branches.
  • In the main-duct-type group, an increase in size of the main pancreatic duct (MPD) was observed in 75% of the patients.
  • CONCLUSIONS: Patients with branch-duct type IPMNs without papillary protrusions or TSS are not immediate candidates for surgery.
  • Those who have small papillary protrusions have a benign course.
  • It is recommended that patients with the large branch-duct type with TSS should undergo surgery.
  • Attention should be paid to the entire pancreas when performing follow-up examinations in patients with branch-duct type IPMN, as invasive ductal adenocarcinoma can develop at a site in the pancreas different from that of the IPMN.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / physiopathology. Carcinoma, Pancreatic Ductal / ultrasonography. Endosonography. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / ultrasonography
  • [MeSH-minor] Adenocarcinoma, Mucinous / pathology. Adenocarcinoma, Mucinous / physiopathology. Adenocarcinoma, Mucinous / surgery. Adenocarcinoma, Mucinous / ultrasonography. Biopsy, Needle. Cholangiopancreatography, Endoscopic Retrograde / methods. Cohort Studies. Disease Progression. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Neoplasm Staging. Pancreatectomy / methods. Retrospective Studies. Risk Assessment

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  • [CommentIn] J Gastroenterol. 2005 Jul;40(7):773-4 [16082600.001]
  • (PMID = 16082592.001).
  • [ISSN] 0944-1174
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Japan
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90. Carter JT, Grenert JP, Rubenstein L, Stewart L, Way LW: Tumors of the ampulla of vater: histopathologic classification and predictors of survival. J Am Coll Surg; 2008 Aug;207(2):210-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • STUDY DESIGN: We analyzed patient demographics, presentation, survival (mean followup 44 months), and tumor histology for 157 consecutive ampullary tumors resected from 1989 to 2006.
  • RESULTS: There were 33 benign (32 adenomas and 1 paraganglioma) and 124 malignant (118 adenocarcinomas and 6 neuroendocrine) tumors.
  • Size of tumor did not predict survival, nor did cribriform/papillary features, dirty necrosis, apical mucin, or nuclear atypia.
  • CONCLUSIONS: In addition to other factors, tumor type (intestinal versus pancreaticobiliary) had a major effect on survival in patients with ampullary adenocarcinoma.
  • The current concept of ampullary adenocarcinoma as a unique entity, distinct from duodenal and pancreatic adenocarcinoma, might be wrong.
  • Intestinal ampullary adenocarcinomas behaved like their duodenal counterparts, but pancreaticobiliary ones were more aggressive and behaved like pancreatic adenocarcinomas.
  • [MeSH-major] Adenocarcinoma / pathology. Ampulla of Vater / pathology. Common Bile Duct Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease Progression. Female. Follow-Up Studies. Humans. Jaundice, Obstructive / mortality. Jaundice, Obstructive / pathology. Jaundice, Obstructive / surgery. Kaplan-Meier Estimate. Lymphatic Metastasis / pathology. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Retrospective Studies. Risk Factors

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  • (PMID = 18656049.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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91. Fujii T, Ishikawa T, Kanazumi N, Sugimoto H, Nomoto S, Inoue S, Nagasaka T, Takeda S, Nakao A: Analysis of clinicopathological features and predictors of malignancy in intraductal papillary mucinous neoplasms of the pancreas. Hepatogastroenterology; 2007 Jan-Feb;54(73):272-7
MedlinePlus Health Information. consumer health - Pancreatic Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We reviewed our experience in order to elucidate predictors of tumor malignancy, invasiveness, and outcome.
  • Patients with invasive carcinomas had significantly shorter survival rates than patients with benign IPMNs or CIS (p < 0.0001).
  • Multivariate analyses revealed that the main duct or the combined type was significantly predictive of malignancy, and both main duct or combined type and diabetes mellitus were associated significantly with invasive carcinoma.
  • CONCLUSIONS: IPMNs generally grow slowly, but have a malignant potential that warrants radical surgical treatment when the tumor component invades the parenchyma.
  • The main duct type of IPMN or IPMN with mural nodules is potentially malignant or invasive.
  • [MeSH-major] Carcinoma, Pancreatic Ductal / pathology. Carcinoma, Papillary / pathology. Pancreatic Neoplasms / pathology
  • [MeSH-minor] Aged. Carcinoma in Situ / pathology. Carcinoma in Situ / surgery. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Invasiveness. Pancreaticoduodenectomy. Retrospective Studies

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  • (PMID = 17419275.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Number-of-references] 32
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92. Uenishi T, Yamazaki O, Tanaka H, Takemura S, Yamamoto T, Tanaka S, Nishiguchi S, Kubo S: Serum cytokeratin 19 fragment (CYFRA21-1) as a prognostic factor in intrahepatic cholangiocarcinoma. Ann Surg Oncol; 2008 Feb;15(2):583-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • RESULTS: Analysis of the areas under the receiver operator characteristic (ROC) curves clearly showed better discrimination between intrahepatic cholangiocarcinoma and benign liver diseases for CYFRA 21-1 than for CEA or CA 19-9.
  • The serum CYFRA21-1 concentration was related to tumor stage, since the CYFRA21-1 concentrations varied according to tumor size, vascular invasion, and number of tumors.
  • On multivariate analysis, a high concentration of CYFRA21-1, nodal metastases, and a microscopic resection margin involvement were independent prognostic factors associated with both tumor recurrence and postoperative death.
  • CONCLUSIONS: A high serum CYFRA21-1 concentration is associated with tumor progression and poor postoperative outcomes in patients with intrahepatic cholangiocarcinoma.
  • [MeSH-major] Antigens, Neoplasm / blood. Bile Duct Neoplasms / blood. Bile Ducts, Intrahepatic. Biomarkers, Tumor / blood. Cholangiocarcinoma / blood. Keratins / blood
  • [MeSH-minor] Aged. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Disease-Free Survival. Female. Humans. Keratin-19. Lymphatic Metastasis. Male. Multivariate Analysis. Neoplasm Invasiveness. Prognosis. ROC Curve. Sensitivity and Specificity

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  • (PMID = 17955299.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; 0 / Keratin-19; 0 / antigen CYFRA21.1; 68238-35-7 / Keratins
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