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Moderate pancreatic duct dysplasia

MedGen UID:
107949
•Concept ID:
C0586364
•
Disease or Syndrome
Synonyms: Grade 2 Pancreatic Intraepithelial Neoplasia; Grade II Pancreatic Intraepithelial Neoplasia; Pancreatic Intraepithelial Neoplasia-2
SNOMED CT: Moderate pancreatic duct dysplasia (308867003)

Definition

A pancreatic mucinous intraepithelial neoplasia characterized by the presence of papillary and less often flat architectural patterns. Moderate cytological atypia is present with some loss of nuclear polarity, nuclear crowding or hyperchromatism. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVModerate pancreatic duct dysplasia

Professional guidelines

PubMed

Pancreatic cyst epithelial denudation: a natural phenomenon in the absence of treatment.
Gómez V, Majumder S, Smyrk TC, Topazian MD, Chari ST, Gleeson FC, Harmsen WS, Enders FT, Abu Dayyeh BK, Iyer PG, Pearson RK, Petersen BT, Rajan E, Takahashi N, Vege SS, Wang KK, Levy MJ
Gastrointest Endosc 2016 Nov;84(5):788-793. Epub 2016 Apr 6 doi: 10.1016/j.gie.2016.03.1502. PMID: 27060714
Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings.
Walter TC, Steffen IG, Stelter LH, Maurer MH, Bahra M, Faber W, Klein F, Bläker H, Hamm B, Denecke T, Grieser C
Eur Radiol 2015 May;25(5):1329-38. Epub 2014 Nov 30 doi: 10.1007/s00330-014-3520-3. PMID: 25433414
Cytology adds value to imaging studies for risk assessment of malignancy in pancreatic mucinous cysts.
Genevay M, Mino-Kenudson M, Yaeger K, Konstantinidis IT, Ferrone CR, Thayer S, Castillo CF, Sahani D, Bounds B, Forcione D, Brugge WR, Pitman MB
Ann Surg 2011 Dec;254(6):977-83. doi: 10.1097/SLA.0b013e3182383118. PMID: 22041510Free PMC Article

Recent clinical studies

Etiology

Intraductal papillary neoplasm of the bile duct: Cytomorphologic and molecular features.
Stendahl K, Gilani SM, Basturk O, Hui P, Sigel C, Cai G
Cancer Cytopathol 2023 Jan;131(1):37-49. Epub 2022 Aug 30 doi: 10.1002/cncy.22637. PMID: 36041224Free PMC Article
A case of intrahepatic cholangiocarcinoma arising from a simple hepatic cyst via dysplasia and carcinomatous transformation.
Tanimura I, Yoneda N, Kitao A, Nio K, Kaneko S, Okazaki M, Ikeda H, Kobayashi S, Gabata T
Abdom Radiol (NY) 2022 Jun;47(6):1954-1960. Epub 2022 Mar 28 doi: 10.1007/s00261-022-03493-6. PMID: 35347383
Prostaglandin E(2): A Pancreatic Fluid Biomarker of Intraductal Papillary Mucinous Neoplasm Dysplasia.
Yip-Schneider MT, Carr RA, Wu H, Schmidt CM
J Am Coll Surg 2017 Oct;225(4):481-487. Epub 2017 Jul 21 doi: 10.1016/j.jamcollsurg.2017.07.521. PMID: 28739154Free PMC Article
Enucleation: A treatment alternative for branch duct intraductal papillary mucinous neoplasms.
Kaiser J, Fritz S, Klauss M, Bergmann F, Hinz U, Strobel O, Schneider L, Büchler MW, Hackert T
Surgery 2017 Mar;161(3):602-610. Epub 2016 Nov 22 doi: 10.1016/j.surg.2016.09.026. PMID: 27884612
Pancreatic main-duct involvement in branch-duct IPMNs: an underestimated risk.
Fritz S, Klauss M, Bergmann F, Strobel O, Schneider L, Werner J, Hackert T, Büchler MW
Ann Surg 2014 Nov;260(5):848-55; discussion 855-6. doi: 10.1097/SLA.0000000000000980. PMID: 25379856

Diagnosis

Intraductal papillary neoplasm of the bile duct: Cytomorphologic and molecular features.
Stendahl K, Gilani SM, Basturk O, Hui P, Sigel C, Cai G
Cancer Cytopathol 2023 Jan;131(1):37-49. Epub 2022 Aug 30 doi: 10.1002/cncy.22637. PMID: 36041224Free PMC Article
A case of intrahepatic cholangiocarcinoma arising from a simple hepatic cyst via dysplasia and carcinomatous transformation.
Tanimura I, Yoneda N, Kitao A, Nio K, Kaneko S, Okazaki M, Ikeda H, Kobayashi S, Gabata T
Abdom Radiol (NY) 2022 Jun;47(6):1954-1960. Epub 2022 Mar 28 doi: 10.1007/s00261-022-03493-6. PMID: 35347383
Pancreatic main-duct involvement in branch-duct IPMNs: an underestimated risk.
Fritz S, Klauss M, Bergmann F, Strobel O, Schneider L, Werner J, Hackert T, Büchler MW
Ann Surg 2014 Nov;260(5):848-55; discussion 855-6. doi: 10.1097/SLA.0000000000000980. PMID: 25379856
Laparoscopic ampullectomy for an ampullarian adenoma.
Borie F, Zarzavadjian Le Bian A
Surg Endosc 2013 Nov;27(11):4385. Epub 2013 Jul 9 doi: 10.1007/s00464-013-3078-1. PMID: 23836126
Unusual manifestation of an ampullary tumor presenting with severe upper gastrointestinal bleeding.
Ashkar K, Deeb LS, Bikhazi K, Arnaout MS
Digestion 1999 Nov-Dec;60(6):583-6. doi: 10.1159/000007711. PMID: 10545731

Therapy

Repeated pancreatectomy after pancreato-duodenectomy for a intraductal papillary mucinous tumour: advantage of pancreatico-gastrostomy with a gastric partition.
Fernández-Cruz L, López-Boado MA, Ferrer J
HPB (Oxford) 2012 Feb;14(2):132-5. Epub 2011 Nov 16 doi: 10.1111/j.1477-2574.2011.00415.x. PMID: 22221575Free PMC Article

Prognosis

Circulating Thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm.
Simpson RE, Yip-Schneider MT, Wu H, Fan H, Liu Z, Korc M, Zhang J, Schmidt CM
Am J Surg 2019 Mar;217(3):425-428. Epub 2018 Sep 7 doi: 10.1016/j.amjsurg.2018.08.026. PMID: 30293901Free PMC Article
Prostaglandin E(2): A Pancreatic Fluid Biomarker of Intraductal Papillary Mucinous Neoplasm Dysplasia.
Yip-Schneider MT, Carr RA, Wu H, Schmidt CM
J Am Coll Surg 2017 Oct;225(4):481-487. Epub 2017 Jul 21 doi: 10.1016/j.jamcollsurg.2017.07.521. PMID: 28739154Free PMC Article
Enucleation: A treatment alternative for branch duct intraductal papillary mucinous neoplasms.
Kaiser J, Fritz S, Klauss M, Bergmann F, Hinz U, Strobel O, Schneider L, Büchler MW, Hackert T
Surgery 2017 Mar;161(3):602-610. Epub 2016 Nov 22 doi: 10.1016/j.surg.2016.09.026. PMID: 27884612
Pancreatic cyst epithelial denudation: a natural phenomenon in the absence of treatment.
Gómez V, Majumder S, Smyrk TC, Topazian MD, Chari ST, Gleeson FC, Harmsen WS, Enders FT, Abu Dayyeh BK, Iyer PG, Pearson RK, Petersen BT, Rajan E, Takahashi N, Vege SS, Wang KK, Levy MJ
Gastrointest Endosc 2016 Nov;84(5):788-793. Epub 2016 Apr 6 doi: 10.1016/j.gie.2016.03.1502. PMID: 27060714
Reduction of pp32 expression in poorly differentiated pancreatic ductal adenocarcinomas and intraductal papillary mucinous neoplasms with moderate dysplasia.
Brody JR, Witkiewicz A, Williams TK, Kadkol SS, Cozzitorto J, Durkan B, Pasternack GR, Yeo CJ
Mod Pathol 2007 Dec;20(12):1238-44. Epub 2007 Sep 28 doi: 10.1038/modpathol.3800974. PMID: 17906614

Clinical prediction guides

Interobserver agreement of pathologic classification and grading of tumoral intraductal pre-invasive neoplasms of the bile duct.
Nakanuma Y, Sato Y, Kakuda Y, Naito Y, Fukumura Y, Fukushima M, Minato H, Aishima S, Ohike N, Furukawa T
Ann Diagn Pathol 2024 Apr;69:152247. Epub 2023 Dec 18 doi: 10.1016/j.anndiagpath.2023.152247. PMID: 38128439
Circulating Thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm.
Simpson RE, Yip-Schneider MT, Wu H, Fan H, Liu Z, Korc M, Zhang J, Schmidt CM
Am J Surg 2019 Mar;217(3):425-428. Epub 2018 Sep 7 doi: 10.1016/j.amjsurg.2018.08.026. PMID: 30293901Free PMC Article
Prostaglandin E(2): A Pancreatic Fluid Biomarker of Intraductal Papillary Mucinous Neoplasm Dysplasia.
Yip-Schneider MT, Carr RA, Wu H, Schmidt CM
J Am Coll Surg 2017 Oct;225(4):481-487. Epub 2017 Jul 21 doi: 10.1016/j.jamcollsurg.2017.07.521. PMID: 28739154Free PMC Article
Pancreatic cyst epithelial denudation: a natural phenomenon in the absence of treatment.
Gómez V, Majumder S, Smyrk TC, Topazian MD, Chari ST, Gleeson FC, Harmsen WS, Enders FT, Abu Dayyeh BK, Iyer PG, Pearson RK, Petersen BT, Rajan E, Takahashi N, Vege SS, Wang KK, Levy MJ
Gastrointest Endosc 2016 Nov;84(5):788-793. Epub 2016 Apr 6 doi: 10.1016/j.gie.2016.03.1502. PMID: 27060714
Prospective evaluation of reader performance on MDCT in characterization of cystic pancreatic lesions and prediction of cyst biologic aggressiveness.
Sahani DV, Sainani NI, Blake MA, Crippa S, Mino-Kenudson M, del-Castillo CF
AJR Am J Roentgenol 2011 Jul;197(1):W53-61. doi: 10.2214/AJR.10.5866. PMID: 21700995

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