Pancreatic ductal adenocarcinomas with multiple large cystic structures : A clinicopathologic and immunohistochemical study of seven cases

Nitta, Takeo; Mitsuhashi, Tomoko; Hatanaka, Yutaka; Hirano, Satoshi; Matsuno, Yoshihiro

Pancreatic ductal adenocarcinomas with multiple large cystic structures : A clinicopathologic and immunohistochemical study of seven cases

Nitta, Takeo; Mitsuhashi, Tomoko; Hatanaka, Yutaka et al.

Pancreatology, 2013, 13(4), 401-408

Permalink : https://hdl.handle.net/2115/53346

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アクセス権	open access
URI	https://hdl.handle.net/2115/53346
タイトル	Pancreatic ductal adenocarcinomas with multiple large cystic structures : A clinicopathologic and immunohistochemical study of seven cases
著者	Nitta, Takeo ; Mitsuhashi, Tomoko ; Hatanaka, Yutaka ; Hirano, Satoshi ; Matsuno, Yoshihiro
著者名 Nitta, Takeo
e-Rad_Researcher 60348208 著者名 Mitsuhashi, Tomoko
e-Rad_Researcher 30589924 著者名 Hatanaka, Yutaka
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
著者名 Matsuno, Yoshihiro
言語	英語
キーワード	Pancreas
	Cyst
	Multiple large cysts
	Ductal adenocarcinoma
	PanIN
発行日	2013
出版者	Karger
収録物名	Pancreatology
巻(号)	13(4)
ページ	401-408
抄録	Background/objectives: Pancreatic ductal adenocarcinoma (PDA) with cystic change is classified into several types according to the features of the cysts; however, those tumors do not constitute a uniform group, and the classification is controversial. In this study, we have described a series of cystic PDAs that show distinctive and previously unreported morphologic and immunohistochemical features. Methods: We analyzed 200 cases of PDA treated surgically at a single institution, and extracted the clinical and histopathological features of 7 tumors showing multiple large cystic (MLC) structure. Results: Preoperative radiographic images revealed a multilocular mass in the pancreas which was similar to intraductal papillary mucinous neoplasm or mucinous cystic neoplasm. These tumors were associated with more than 5 large cystic structures and numerous intratumoral microcysts lined by epithelial cells with various degrees of atypia. The average maximal diameter of the cysts (3.7 cm) was much larger than that of previously reported. Immunohistochemically, the cyst-lining epithelia were almost negative for mucin core protein (MUC) 1, MUC2, and MUC6, and showed only focal staining for MUC5AC. Maspin, CEA, and p53 were strongly positive, and the Ki-67 labeling index was high in both cells in solid areas and cyst-lining epithelia. Conclusion: We considered the MLC structures in PDA to be a mixture of ectatic neoplastic glands and retention cysts with ductal cancerization or pancreatic intraepithelial neoplasia (PanIN); however, they might represent a new entity of cystic PDA because of the unusually large size of the dilated cysts. Copyright (C) 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	1424-3903
NCID	AA11583711
関連情報	PMID 23890139
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.pan.2013.05.004