臨牀消化器内科 Vol.24 No.9(3)


特集名 膵管内乳頭粘液性腫瘍(IPMN)
題名 IPMNの病理
発刊年月 2009年 08月
著者 古川 徹 東京女子医科大学国際統合医科学インスティテュート
【 要旨 】 IPMNは肉眼的に認識可能な拡張した膵管を主徴とし,拡張膵管内に粘液産生性の乳頭状を呈する上皮性腫瘍として認められる.IPMNの診断は異型度,浸潤の有無による.鑑別疾患として囊胞性腫瘍,膵管内管状腫瘍,膵上皮内腫瘍性病変(PanIN)があげられる.IPMNは肉眼的に主膵管型,分枝膵管型,混合型に分けられ,また,組織学的な乳頭の構造により胃上皮型,腸上皮型,膵胆道上皮型,好酸性/膨大細胞型の4種の亜型に分けられる.診断,肉眼型,組織学的亜型は互いに,また,予後と相関する.
Theme Intraductal Papillary Mucinous Neoplasm (IPMN)
Title Pathology of Intraductal Papillary Mucinous Neoplasms
Author Toru Furukawa International Research and Educational Institute for Integrated Medical Sciences, Tokyo Women's Medical University
[ Summary ] Intraductal papillary mucinous neoplasms (IPMN) are characterized by mucinous papillae developing in dilated pancreatic ducts. A diagnosis of IPMN is made according to the degree of atypia and invasion of neoplastic cells. Differential diagnoses includes cystic neoplasms, intraductal tubular neoplasms, and pancreatic intraepithelial neoplasia. Macroscopic images of IPMN are classified into the main duct type, the branch duct type or the mixed type. Microscopic morphological variations of papillae of IPMN are classified into gastric, intestinal, pancreatobiliary, or oncocytic types. The diagnosis, the macroscopic type, and the microscopic type of IPMN areassociated with each other as well as prognosis.
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