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Case Reports
. 2015 Feb;100(2):281-6.
doi: 10.9738/INTSURG-D-14-00172.1.

A resected case of intraductal tubulopapillary neoplasm of the pancreas: report of a case

Kazuhiko Kitaguchi  1 , Yuichiro Kato, Motohiro Kojima, Satoshi Okubo, Daigoro Takahashi, Rei Okada, Yusuke Nakayama, Yasunori Nishida, Naoto Gotohda, Shinichiro Takahashi, Masaru Konishi
Affiliations
Case Reports

A resected case of intraductal tubulopapillary neoplasm of the pancreas: report of a case

Kazuhiko Kitaguchi et al. Int Surg. 2015 Feb.

Abstract

The patient was a 61-year-old male who was referred to our hospital after dilatation of the main pancreatic duct was detected by screening ultrasonography. Computed tomography revealed a protruding lesion measuring 15 mm in diameter within the main pancreatic duct in the head of the pancreas, and magnetic resonance cholangiopancreatography revealed interruption of the duct at the tumor site. We performed pancreaticoduodenectomy under a suspected diagnosis of invasive ductal carcinoma. Gross examination of the resected specimen showed that the tumor invaginated into the main pancreatic duct, and no mucin was found. Histological examination revealed proliferation of high-grade dysplastic cells in a tubulopapillary growth pattern. Immunohistochemically, cytokeratin 7 expression was detected, but not trypsin expression. Based on these morphological features, we diagnosed the tumor as intraductal tubulopapillary neoplasm (ITPN). We report the case with bibliographic consideration, together with a review of intraductal neoplasms of the pancreas encountered at our institution.

Keywords: Intraductal neoplasms of the pancreas; Intraductal tubulopapillary neoplasm (ITPN); Pancreaticoduodenectomy.

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Figures

Fig. 1
Fig. 1
Abdominal ultrasonography. (a) Dilatation of the main pancreatic duct is seen (arrowhead), ranging from the pancreas body to the pancreas tail. (b) A protruded lesion (arrowhead) measuring 16 mm in diameter is seen within the main pancreatic duct.
Fig. 2
Fig. 2
Abdominal CT and MRCP. (a) CT revealed dilatation of the main pancreatic duct in the region of the body and tail of the pancreas (arrowhead). (b, c) A mass lesion (arrowhead) is seen in the head, which showed persistent enhancement after administration of contrast material. (d) MRCP revealed interruption of the main pancreatic duct at the tumor site, and beaded dilatation of the duct in the region of the body and tail of the pancreas.
Fig. 3
Fig. 3
Gross examination of the resected specimen showed absence of mucin and a solid tumor (arrowhead), measuring 12 × 9 mm, invaginating into the main pancreatic duct.
Fig. 4
Fig. 4
Histopathological findings. (a) The tumor was composed of cuboidal uniformly high-grade dysplastic cells proliferating in a tubulopapillary growth pattern. (b) Only a small part of the tumor showed interstitial infiltration. (c, d) The tumor cells were positive for CK7, and negative for trypsin.
See this image and copyright information in PMC

References

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