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Intraductal Papillary Mucinous Neoplasms of Pancreas: The Good, the Bad, and the Ugly.

Mondal U, Echavarria J, Lee G, Patel S, Rosenkranz L - ACG Case Rep J (2015)

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Nutrition, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.

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Intraductal papillary mucinous neoplasms (IPMN) arise from main pancreatic duct (MD-IPMN) and/or branch ducts (BDIPMN), and are characterized by intraductal papillary proliferation of mucin-producing epithelial cells exhibiting various degrees of dysplasia... The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use... The Bad: A 77-year-old man with history of heavy alcohol and tobacco use presented with unintended weight loss and recurrent episodes of abdominal pain... EUS showed segmental dilation of the pancreatic duct (PD) up to 20 mm in the body of pancreas, no mural nodules, and no chronic pancreatitis... Pancreatos-copy showed mucous plug obstructing a gaping papilla (Figure 3) and an MD-IPMN with mural nodules (papillary projections) giving a “fish egg” appearance (Figure 3)... The patient was evaluated for surgical resection, but he decided to undergo close surveillance... The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain... Lee obtained the images... Patel and L... Rosenkranz revised the manuscript... Financial disclosure: None to report... Informed consent was obtained for this case report.

No MeSH data available.


Dilated main pancreatic duct with mucous but no irregularities.
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Figure 2: Dilated main pancreatic duct with mucous but no irregularities.

Mentions: The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use. Endoscopic ultrasound (EUS) showed chronic pancreatitis with but no mural nodules. Pancreatoscopy showed a widely patent papilla with gaping or “fish mouth” appearance (Figure 1) and diffusely dilated duct with mucous (Figure 2), suggestive of MD-IPMN. Intraductal biopsies showed inflammatory changes but no dysplasia. Recommendations were made per guidelines and the patient elected to pursue surveillance.2 She remained healthy 3 years since diagnosis.


Intraductal Papillary Mucinous Neoplasms of Pancreas: The Good, the Bad, and the Ugly.

Mondal U, Echavarria J, Lee G, Patel S, Rosenkranz L - ACG Case Rep J (2015)

Dilated main pancreatic duct with mucous but no irregularities.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508940&req=5

Figure 2: Dilated main pancreatic duct with mucous but no irregularities.
Mentions: The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use. Endoscopic ultrasound (EUS) showed chronic pancreatitis with but no mural nodules. Pancreatoscopy showed a widely patent papilla with gaping or “fish mouth” appearance (Figure 1) and diffusely dilated duct with mucous (Figure 2), suggestive of MD-IPMN. Intraductal biopsies showed inflammatory changes but no dysplasia. Recommendations were made per guidelines and the patient elected to pursue surveillance.2 She remained healthy 3 years since diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Nutrition, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Intraductal papillary mucinous neoplasms (IPMN) arise from main pancreatic duct (MD-IPMN) and/or branch ducts (BDIPMN), and are characterized by intraductal papillary proliferation of mucin-producing epithelial cells exhibiting various degrees of dysplasia... The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use... The Bad: A 77-year-old man with history of heavy alcohol and tobacco use presented with unintended weight loss and recurrent episodes of abdominal pain... EUS showed segmental dilation of the pancreatic duct (PD) up to 20 mm in the body of pancreas, no mural nodules, and no chronic pancreatitis... Pancreatos-copy showed mucous plug obstructing a gaping papilla (Figure 3) and an MD-IPMN with mural nodules (papillary projections) giving a “fish egg” appearance (Figure 3)... The patient was evaluated for surgical resection, but he decided to undergo close surveillance... The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain... Lee obtained the images... Patel and L... Rosenkranz revised the manuscript... Financial disclosure: None to report... Informed consent was obtained for this case report.

No MeSH data available.