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首页> 外文期刊>Familial cancer >Multiple small 'imaging' branch-duct type intraductal papillary mucinous neoplasms (IPMNs) in familial pancreatic cancer: Indicator for concomitant high grade pancreatic intraepithelial neoplasia?
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Multiple small 'imaging' branch-duct type intraductal papillary mucinous neoplasms (IPMNs) in familial pancreatic cancer: Indicator for concomitant high grade pancreatic intraepithelial neoplasia?

机译：家族性胰腺癌中的多个小“影像”分支导管型导管内乳头状黏液性肿瘤（IPMN）：伴有高级别胰腺上皮内瘤变的指标？

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Most screening programs for familial pancreatic cancer are currently based on endoscopic ultrasonography and/or magnetic resonance imaging (MRI). Cystic lesions, especially those suspicious for small intraductal pancreatic mucinous neoplasms (IPMNs) of the branch ducts, can be visualized in up to 40 % of individuals at risk, but their pathological importance in the setting of FPC is yet not well established. Individuals at risk from a prospective screening program for familial pancreatic cancer with small "imaging" IPMNs of the branch-duct type (BD-IPMN) who underwent pancreatic resection were analysed regarding clinico-pathological data and the locations of pancreatic lesions. Five of 125 individuals at risk who underwent screening had multiple small (size 2-10 mm) unicystic lesions and/or multicystic single lesions in the pancreatic body and tail suspicious for BD-IPMNs upon MRI imaging and decided to undergo surgical resection after interdisciplinary counselling, although none fulfilled the consensus criteria for IPMN resection. Histological examination revealed BD-IPMNs with low or moderate dysplasia of the gastric type in combination with multifocal PanIN2 and PanIN3 lesions in 4 individuals. The remaining patient had only tiny ductectasias in the pancreatic tail with multifocal PanIN 2 lesions in the entire gland and one PanIN3 lesion in the pancreatic head. Intriguingly, the location of the most dysplastic histological lesions (PanIN3) did not correspond to the preoperatively detected lesions and were not visible in preoperative imaging. In the setting of FPC, the presence of multiple small "imaging" BD-IPMNs may indicate the presence of high-grade PanIN lesions elsewhere in the pancreas. ? 2012 Springer Science+Business Media Dordrecht.
机译：目前，大多数家族性胰腺癌的筛查程序都基于内窥镜超声检查和/或磁共振成像（MRI）。囊性病变，特别是那些可疑的分支导管小导管内胰腺粘液性肿瘤（IPMN）的囊性病变，可以在多达40％的高危人群中看到，但它们在FPC设置中的病理学重要性尚不明确。对接受胰腺切除的家族性胰腺癌伴分支切除型小“影像” IPMN（BD-IPMN）的前瞻性筛查计划存在风险的个体进行了临床病理学数据和胰腺病变位置的分析。接受筛查的125位有风险的个体中有5位在MRI成像时在胰体和尾部有多个小（2-10毫米大小）单囊性病变和/或多囊性单病变，并怀疑BD-IPMN，并决定在接受跨学科咨询后进行手术切除，尽管没有一个符合IPMN切除的共识标准。组织学检查显示，有4名个体的BD-IPMNs伴有多灶性PanIN2和PanIN3病变伴有胃中低度或中度不典型增生。其余患者仅在胰尾部有微小的导管扩张，在整个腺体中有多灶性PanIN 2病变，在胰头中有1个PanIN3病变。有趣的是，最不典型的组织学病变（PanIN3）的位置与术前检测到的病变并不对应，并且在术前成像中不可见。在FPC的情况下，多个小的“成像” BD-IPMN的存在可能表明胰腺其他部位存在高级别PanIN病变。 ？ 2012年Springer Science +商业媒体多德雷赫特。

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