Περίληψη:
Objectives This study aims to evaluate the performance of clinical, imaging, and cytopathological criteria in the identification of high-grade dysplasia/carcinoma (HGD/Ca) in pancreatic mucin-producing cystic neoplasms. Methods Sixty-eight consecutive, histopathologically confirmed mucin-producing cystic neoplasms, evaluated by endoscopic ultrasound-guided fine-needle aspiration, were enrolled; specifically, 39 branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), 21 main duct IPMNs, and 8 mucinous cystic neoplasms. The associations between HGD/Ca in histopathology and findings of endoscopic ultrasound and cytology, demographic, lifestyle, and clinical parameters were evaluated, separately in IPMNs and mucinous cystic neoplasms. Results Age 65 years or more was associated with HGD/Ca in IPMNs. In BD-IPMNs, cyst diameter 3 cm or greater (sensitivity, 68.8%; specificity, 65.2%), a mural nodule (sensitivity, 56.3%; specificity, 78.3%), main pancreatic duct diameter 5 to 9 mm (sensitivity, 50.0%; specificity, 87.0%), and suspicious cytology (sensitivity, 81.3%; specificity, 100%) signaled the presence of HGD/Ca. Similarly, in main duct IPMNs, suspicious cytology predicted HGD/Ca with high sensitivity (88.9%) and excellent specificity (100%). Regarding cytopathological criteria, in BD-IPMNs, HGD/Ca was associated with a high nuclear/cytoplasmic ratio, background necrosis, presence of papillary structures, hypochromatic nuclei, hyperchromatic nuclei, and major nuclear membrane irregularities (thickening and/or indentations). Conclusions Clinical, imaging, and cytopathological criteria are useful in the identification of HGD/Ca in IPMNs. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Salla, C.
Karvouni, E.
Nikas, I.
Ikonomakis, A.
Konstantinou, P.
Karoumpalis, I.
Sepsa, A.
Papaparaskeva, K.
Tsopanomichalou, M.
Georgiadou, D.
Kostopoulou, A.
Tsiotos, G.
Theocharis, S.
Sergentanis, T.N.
Politi, E.
Λέξεις-κλειδιά:
mucin, adult; Article; branch duct intraductal papillary mucinous neoplasm; computer assisted tomography; cytopathology; endoscopic ultrasonography; endoscopic ultrasound guided fine needle biopsy; female; human; intraductal papillary mucinous tumor; magnetic resonance cholangiopancreatography; major clinical study; male; mucinous cystic neoplasm; nuclear magnetic resonance imaging; priority journal; prospective study; sensitivity and specificity; aged; colloid carcinoma; diagnostic imaging; middle aged; neoplasm; pancreas; pancreas carcinoma; pancreas tumor; papillary carcinoma; pathology; procedures, Adenocarcinoma, Mucinous; Aged; Carcinoma, Pancreatic Ductal; Carcinoma, Papillary; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Female; Humans; Male; Middle Aged; Neoplasms, Cystic, Mucinous, and Serous; Pancreas; Pancreatic Neoplasms
