| Theme |
Intraductal Papillary Mucinous Neoplasm (IPMN) |
| Title |
Intraductal Papillary Mucinous Neoplasms and Pancreatic Intraepithelial Neoplasia |
| Author |
Tkyoichi Takaori |
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine |
| Author |
Akihiko Yoshizawa |
Department of Diagnostic Pathology, Kyoto University Hospital |
| Author |
Yoshiya Kawaguchi |
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine |
| Author |
Ryuichiro Doi |
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine |
| Author |
Toshiaki Manabe |
Department of Diagnostic Pathology, Kyoto University Hospital |
| Author |
Shinji Uemoto |
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine |
| [ Summary ] |
Pancreatic cancer is a devastating disease with a bleak prognosis. In contrast, intraductal papillary mucinous neoplasms, or IPMNs, are known for their good prognoses. As is true with other cancers, genetic alterations give rise to pancreatic cancer. Pancreatic intraepithelial neoplasia, or PanIN, has been proposed as a precursor lesion for pancreatic cancer and step-wise accumulation of genetic alterations has been demonstrated in PanINlesions. Similar, albeit not identical, step-wise accumulation of genetic alterations has been reported in IPMNs as well. Besides, it has been acknowledged that some IPMNs progress toward invasive tubular carcinomas, which is the most common histological phenotype of pancreatic cancer. Therefore, both PanIN and IPMNs are now considered precursors to pancreatic cancer. When both IPMNs and high-grade PanIN are manifested concomitantly in a single pancreas, it must be noted that the high-grade PanIN may first progress toward pancreatic cancer. Since IPMNs and PanIN share several common features, such as papillary growth in the pancreatic ducts, it is not always easy to differentially diagnose IPMNs and PanIN. In this paper, guidelines for differential diagnosis of PanIN and IPMNs are presented. The clinicopathological features of IPMNs and PanIN are also described herein with special references to genetic alterations. |