Intraductal papillary mucinous neoplasm (IPMN) of the gastric-type with focal nodular growth of the arborizing papillae: a case of high-grade transformation of the gastric-type IPMN.

Virchows Archiv : an International Journal of Pathology
Shinichi BanIsamu Koyama

Abstract

We present a case of intraductal papillary mucinous neoplasm (IPMN) of the pancreas, demonstrating a process of high-grade transformation of the gastric-type IPMN. An 83-year-old Japanese woman underwent pylorus-preserving pancreatoduodenectomy for removal of a multicystic mass of the pancreas head, which had been followed up for 7 years. The removed tumor was a low-grade gastric-type IPMN spreading in the branch ducts, focally forming an intraluminal nodular lesion. The nodular lesion was comprised of arborizing papillotubular proliferation of cuboidal to columnar epithelia with high-grade atypia, and was characterized by diffuse MUC1 expression and a gastric mucin phenotype (focal MUC5AC and MUC6 expressions). Therefore, the nodular lesion was consistent with the pancreatobiliary-type IPMN, and the present case suggests that the low-grade gastric-type IPMN may progress to a focal intraductal carcinoma over the years, and the pancreatobiliary-type IPMN may be one of the forms of such high-grade transformation of the gastric-type IPMN. One of the cystic lesions was an oligocystic-type serous cystic neoplasm (serous cystadenoma), which might be an incidental concomitance or have a common basis.

References

Sep 5, 2002·The Journal of Pathology·Benoît TerrisJean-Francois Fléjou
Aug 10, 2005·Virchows Archiv : an International Journal of Pathology·Toru FurukawaSuguru Yonezawa

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Citations

Sep 28, 2007·Virchows Archiv : an International Journal of Pathology·Snezana Andrejevic-BlantGünter Klöppel
Dec 15, 2010·The Oncologist·Robert GrützmannHans D Saeger
Oct 3, 2013·International Journal of Molecular Sciences·Antonio GnoniNicola Silvestris
Oct 13, 2012·Pathology, Research and Practice·Takuma TajiriToshio Morohoshi
Oct 2, 2007·Histopathology·F Campbell, B Azadeh
Jul 9, 2013·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Hisashi KasugaiShin-ei Kudo

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