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Pancreatic intraductal papillary mucinous neoplasm with concomitant heterotopic pancreatic cystic neoplasia of the stomach: a case report and review of the literature.

Tsapralis D, Charalabopoulos A, Karamitopoulou E, Schizas D, Charalabopoulos K, Liakakos T, Macheras A - Diagn Pathol (2010)

Bottom Line: During surgery, a subserosal polypoid mass was noted at the greater curvature of the gastric antrum and was enucleated.This mass was proven to be heterotopic pancreatic tissue with cystic neoplasia of the IPMN histologic subtype.Through an extensive search of the literature, we found that this is the first case ever reported with simultaneous existence of IPMN changes, in the main and secondary ducts of the orthotopic pancreas and in the heterotopic pancreatic tissue of the gastric wall.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Athens University Medical School, Attikon University Hospital, Athens, Greece.

ABSTRACT
A 60-year-old Caucasian male underwent a total pancreatectomy for a mixed type pancreatic intraductal papillary mucinous neoplasm (IPMN) arising in the main and secondary pancreatic ducts. During surgery, a subserosal polypoid mass was noted at the greater curvature of the gastric antrum and was enucleated. This mass was proven to be heterotopic pancreatic tissue with cystic neoplasia of the IPMN histologic subtype. Through an extensive search of the literature, we found that this is the first case ever reported with simultaneous existence of IPMN changes, in the main and secondary ducts of the orthotopic pancreas and in the heterotopic pancreatic tissue of the gastric wall.

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IPMN in orthotopic pancreas. a. Well-developed papillary projections within the duct. There is architectural and nuclear atypia. (H+E ×200), b. Budding off of clusters of neoplastic cells into the lumen (H+E ×400).
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Figure 2: IPMN in orthotopic pancreas. a. Well-developed papillary projections within the duct. There is architectural and nuclear atypia. (H+E ×200), b. Budding off of clusters of neoplastic cells into the lumen (H+E ×400).

Mentions: Histologic examination of the orthotopic pancreas revealed a non-invasive intraductal papillary mucinous neoplasm involving the main pancreatic duct, with prominent intraductal papillary projections (Figure 2a). The papillae were well-developed with a fibrovascular core. The neoplastic epithelial cells showed intestinal differentiation. The neoplasm exhibited significant architectural and nuclear atypia. There was budding off of clusters of neoplastic cells into the lumen, as well as, significant nuclear pleomorphism with loss of polarity and prominent nucleoli (IPMN with high grade dysplasia; figure 2b).


Pancreatic intraductal papillary mucinous neoplasm with concomitant heterotopic pancreatic cystic neoplasia of the stomach: a case report and review of the literature.

Tsapralis D, Charalabopoulos A, Karamitopoulou E, Schizas D, Charalabopoulos K, Liakakos T, Macheras A - Diagn Pathol (2010)

IPMN in orthotopic pancreas. a. Well-developed papillary projections within the duct. There is architectural and nuclear atypia. (H+E ×200), b. Budding off of clusters of neoplastic cells into the lumen (H+E ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823681&req=5

Figure 2: IPMN in orthotopic pancreas. a. Well-developed papillary projections within the duct. There is architectural and nuclear atypia. (H+E ×200), b. Budding off of clusters of neoplastic cells into the lumen (H+E ×400).
Mentions: Histologic examination of the orthotopic pancreas revealed a non-invasive intraductal papillary mucinous neoplasm involving the main pancreatic duct, with prominent intraductal papillary projections (Figure 2a). The papillae were well-developed with a fibrovascular core. The neoplastic epithelial cells showed intestinal differentiation. The neoplasm exhibited significant architectural and nuclear atypia. There was budding off of clusters of neoplastic cells into the lumen, as well as, significant nuclear pleomorphism with loss of polarity and prominent nucleoli (IPMN with high grade dysplasia; figure 2b).

Bottom Line: During surgery, a subserosal polypoid mass was noted at the greater curvature of the gastric antrum and was enucleated.This mass was proven to be heterotopic pancreatic tissue with cystic neoplasia of the IPMN histologic subtype.Through an extensive search of the literature, we found that this is the first case ever reported with simultaneous existence of IPMN changes, in the main and secondary ducts of the orthotopic pancreas and in the heterotopic pancreatic tissue of the gastric wall.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Athens University Medical School, Attikon University Hospital, Athens, Greece.

ABSTRACT
A 60-year-old Caucasian male underwent a total pancreatectomy for a mixed type pancreatic intraductal papillary mucinous neoplasm (IPMN) arising in the main and secondary pancreatic ducts. During surgery, a subserosal polypoid mass was noted at the greater curvature of the gastric antrum and was enucleated. This mass was proven to be heterotopic pancreatic tissue with cystic neoplasia of the IPMN histologic subtype. Through an extensive search of the literature, we found that this is the first case ever reported with simultaneous existence of IPMN changes, in the main and secondary ducts of the orthotopic pancreas and in the heterotopic pancreatic tissue of the gastric wall.

Show MeSH
Related in: MedlinePlus