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A resected case of two branch duct-type intraductal papillary mucinous neoplasms showing different clinical courses after a two-year follow-up.
- Source :
- Clinical Journal of Gastroenterology; Jun2017, Vol. 10 Issue 3, p274-278, 5p
- Publication Year :
- 2017
-
Abstract
- The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN ( b), 16 mm in size] and tail [BD-IPMN ( t), 13 mm in size] without a 'high-risk stigmata' or 'worrisome features'. He subsequently received follow-up by MRCP every 6 months. Two years later, MRCP showed prominent dilation of the main pancreatic duct (MPD) and mural nodule formation within the dilated MPD adjacent to the BD-IPMN ( b). Distal pancreatectomy specimens revealed that the BD-IPMN ( b) was lined by low-papillary gastric mucinous epithelium with low-to-intermediate-grade dysplasia and involved the MPD, forming a malignant mural nodule showing pancreatobiliary-type IPMN. In contrast, the BD-IPMN ( t) was lined by flat, monolayer columnar gastric mucinous epithelium without atypia, which suggested the possibility of a 'simple mucinous cyst'. A genetic analysis showed KRAS mutation only in BD-IPMN ( b). Differences in the histological and genetic findings between two similar BD-IPMNs in the present case may suggest what kinds of examinations should be performed in patients with BD-IPMNs without any worrisome features. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18657257
- Volume :
- 10
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Clinical Journal of Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 123024155
- Full Text :
- https://doi.org/10.1007/s12328-017-0728-1