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Case Reports
. 2023 May;164(6):898-905.
doi: 10.1053/j.gastro.2023.02.026. Epub 2023 Mar 1.

A Case of an Incidental Pancreatic Cyst

Elham Afghani  1 , Aatur D Singhi  2 , Anne Marie Lennon  3 , Marco Del Chiaro  4
Affiliations
Case Reports

A Case of an Incidental Pancreatic Cyst

Elham Afghani et al. Gastroenterology. 2023 May.
No abstract available

Keywords: IPMN; Molecular Marker; Pancreatic Cancer; Pancreatic Cyst.

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Conflict of interest statement

Conflicts of interest

These authors disclose the following: Dr Singhi received an honorarium from Foundation Medicine in the area of solid tumor molecular testing. Dr del Chiaro is co-principal investigator of a Boston Scientific–sponsored multi-center study for the use of intra-operative pancreatoscopy in IPMN patients and he has been awarded an industry grant (from Haemonetics) to conduct a multi-center study to evaluate the prognostic implications of TEG in pancreas cancer. The remaining authors disclose no conflicts.

Figures

Figure 1.
Figure 1.
Concerning features on imaging. (A) Magnetic resonance imaging (MRI) showing an intraductal papillary mucinous neoplasm (IPMN) with mural nodule (arrow). (B) MRI showing a diffusely dilated main pancreatic duct (arrow) consistent with main-duct IPMN. (C) Endoscopic ultrasound (EUS) showing an abrupt cut-off of the main pancreatic duct with a solid pancreatic mass (arrow) that was confirmed as a pancreatic adenocarcinoma on cytology. (D) A mural nodule obstructing the main pancreatic cyst (arrow). (E). Mucin (arrow) within cyst. (F) Magnified view of mucin within main pancreatic duct. (G) Dilated main pancreatic duct in the body of the pancreas. (H) Mixed-type IPMN with dilated main pancreatic duct (blue arrowhead) and branch-duct IPMNs (arrow).
Figure 2.
Figure 2.
Intraductal papillary mucinous neoplasm (IPMN) management based on the practice at Johns Hopkins University School of Medicine, University of Pittsburgh School of Medicine, and University of Colorado School of Medicine. EUS, endoscopic ultrasound; MRI, magnetic resonance imaging.
Figure 3.
Figure 3.
Histologic images of the present patient. (A) Consistent with a mixed-type intraductal papillary mucinous neoplasm (IPMN) (arrowhead), the branch and main pancreatic ducts were involved by a papillary and mucinous neoplasm. (B) High-grade dysplasia extensively involved the IPMN and was characterized by both architectural and cytologic atypia. (C) The cytologic atypia consisted of loss of polarity, anisonucleosis, and hyperchromasia.
See this image and copyright information in PMC

References

    1. Oyama H, Tada M, Takagi K, et al. Long-term risk of malignancy in branch-duct intraductal papillary mucinous neoplasms. Gastroenterology 2020;158:226–237.e5. - PubMed
    1. Pergolini I, Sahora K, Ferrone CR, et al. Long-term risk of pancreatic malignancy in patients with branch duct intraductal papillary mucinous neoplasm in a referral center. Gastroenterology 2017;153:1284–1294.e1. - PubMed
    1. Elta GH, Enestvedt BK, Sauer BG, et al. ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol 2018;113:464–479. - PubMed
    1. European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018;67:789–804. - PMC - PubMed
    1. Vege SS, Ziring B, Jain R, et al. American Gastroenterological Association Institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015;148:819–823. - PubMed

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