A case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm (IPMN)

详细信息    查看全文

• 作者：Yuichi Kawai (1)
  Rei Nakamichi (1)
  Noriko Kamata (1)
  Hideo Miyake (2)
  Masahiko Fujino (3)
  Shigeki Itoh (1)
  
  1. Department of Diagnostic Radiology ; Japanese Red Cross Nagoya Daiichi Hospital ; 3-35 Michishita-cho ; Nakamura-ku ; Nagoya ; Aichi ; 453-8511 ; Japan
  2. General and Gastroenterological Surgery ; Japanese Red Cross Nagoya Daiichi Hospital ; Nagoya ; Japan
  3. Department of Pathology ; Japanese Red Cross Nagoya Daiichi Hospital ; Nagoya ; Japan
  
• 关键词：Undifferentiated carcinoma of the pancreas ; Main ; duct intraductal papillary mucinous neoplasm ; Intraductal tumor growth ; Main pancreatic duct dilatation
• 刊名：Abdominal Imaging
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：40
• 期：3
• 页码：466-470
• 全文大小：1,169 KB
• 参考文献：1. Adsay NV, Fukushima N, Furukawa T, et al. (2010) / Intraductal neoplasms of the pancreas. WHO classification of Tumours of the Digestive System, 4th ed. Lyon: IARC Press, pp 304鈥?13
  2. Paal E, Thompson LD, Frommelt RA, Przygodzki RM, Heffess CS (2001) A clinicopathologic and immunohistochemical study of 35 anaplastic carcinomas of the pancreas with a review of the literature. Ann Diagn Pathol 5(3):129鈥?40 CrossRef
  3. Strobel O, Hartwig W, Bergmann F, et al. (2011) Anaplastic pancreatic cancer: Presentation, surgical management, and outcome. Surgery 149(2):200鈥?08. doi:10.1016/j.surg.2010.04.026 CrossRef
  4. Matsumura Y, Iwai K, Kawasaki R, et al. (2007) A case of spontaneously ruptured anaplastic carcinoma (giant cell type) of the pancreas with intraabdominal hemorrhage. Jpn J Gastroenterol Surg 40:456鈥?61. doi:10.5833/jjgs.40.456 CrossRef
  5. Ichikawa T, Federle MP, Ohba S, et al. (2000) Atypical exocrine and endocrine pancreatic tumors (anaplastic, small cell, and giant cell types): CT and pathologic features in 14 patients. Abdom Imaging 25(4):409鈥?19 CrossRef
  6. Maksymov V, Khalifa MA, Bussey A, Carter B, Hogan M (2011) Undifferentiated (anaplatic) carcinoma of the pancreas with osteoclast-like giant cells showing various degree of pancreas duct involvement. A case report and literature review. JOP 12(2):170鈥?76
  7. Yamano T, Hirai R, Kuroda M, et al. (2013) A case of anaplastic ductal carcinoma with tumor thrombus in the main pancreatic duct. J Jpn Surg Assoc 74:1053鈥?059 CrossRef
  8. Suzuki S, Harada N, Suzuki M, Hanyu F (2007) A case of pleomorphic carcinoma of the pancreas. Suizo 22:137鈥?42 CrossRef
  9. Isaka T, Mizuno N, Takahashi K, et al. (2005) A case of anaplastic carcinoma (giant cell carcinoma of osteoclastoid type) with portal vein and main pancreatic ductal invasion. Jpn J Gastroenterol 102(6):736鈥?40
  10. Higuchi R, Hatori H, Fukuda A, et al. (2004) A case of spindle cell type anaplastic carcinoma of the pancreas. Suizo 19:516鈥?21
  11. Mizukami Y, Arisato S, Satou K, et al. (1997) A case of anaplastic carcinoma of the pancreas, disclosed a hemosuccus pancreaticus. Jpn J Gastroenterol 94(10):706鈥?11
  12. Shirobe T, Yamamoto T, Mori T, et al. (1995) A case of spindle cell carcinoma of the pancreas. Suizo 10:387鈥?92
  13. Okazaki M, Makino I, Kitagawa H, et al. (2014) A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. World J Gastroenterol 20(3):852鈥?56. doi:10.3748/wjg.v20.i3.852 CrossRef
  14. Ishii S, Kobayashi G, Fujita N, et al. (2012) Undifferentiated carcinoma of the pancreas involving intraductal pedunculated polypoid growth. Intern Med 51:3373鈥?377. doi:10.2169/internalmedicine.51.8779 CrossRef
  15. Nara S (2010) A case of anaplastic carcinoma of the pancreas with portal vein tumor thrombus. Jpn J Clin Oncol 40(1):96鈥?7. doi:10.1093/jjco/hyp189 CrossRef
  16. Kuroda N, Iwamura S, Fujishima N, et al. (2007) Anaplastic carcinoma of the pancreas with rhabdoid features and hyaline globule-like structures. Med Mol Morphol 40(3):168鈥?71 CrossRef
  17. Tezuka K, Yamakawa M, Jingu A, Ikeda Y, Kimura W (2006) An unusual case of undifferentiated carcinoma in situ with osteoclast-like giant cells of the pancreas. Pancreas 33(3):304鈥?10 CrossRef
  18. Bergmann F, Esposito I, Michalski CW, et al. (2007) Early undifferentiated pancreatic carcinoma with osteoclastlike giant cells: direct evidence for ductal evolution. Am J Surg Pathol 31(12):1919鈥?925 CrossRef
  19. Castellano-Megias VM, Andres CI, Lopez-Alonso G, et al. (2014) Pathological features and diagnosis of intraductal papillary mucinous neoplasm of the pancreas. World J Gastrointest Oncol 6(9):311鈥?24. doi:10.4251/wjgo.v6.i9.311 CrossRef
  20. Ishigami K, Yoshimitsu K, Irie H, et al. (2008) Imaging of intraductal tubular tumors of the pancreas. AJR Am J Roentgenol 191(6):1836鈥?840. doi:10.2214/AJR.07.4005 CrossRef
  21. Yazawa N, Imaizumi T, Okada K, et al. (2011) Nonfunctioning pancreatic endocrine tumor with extension into the main pancreatic duct: report of a case. Surg Today 41(5):737鈥?40. doi:10.1007/s00595-009-4321-1 CrossRef
  22. Imamura M, Kimura Y, Ito H, et al. (2009) Acinar cell carcinoma of the pancreas with intraductal growth: report of a case. Surg Today 39(11):1006鈥?009. doi:10.1007/s00595-009-3968-y CrossRef
  23. Onoe S, Katoh T, Shibata Y, et al. (2007) A case of acinar cell carcinoma of the pancreas with intraductal tumor growth to the main pancreatic duct. Jpn J Gastroenterol Surg 40:313鈥?18. doi:10.5833/jjgs.40.313 CrossRef
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Gastroenterology
  Hepatology
  
• 出版者：Springer New York
• ISSN：1432-0509

文摘

We report here a rare case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm. In an 80-year-old woman, an approximately 8-mm papillary mass was incidentally detected at the downstream edge of a dilatated main pancreatic duct lumen on CT and MRI. Main pancreatic duct dilatation in the pancreatic body and tail and parenchymal atrophy were observed in the upstream of the mass. Histopathologically, the tumor protruded into the downstream edge of the dilatated main pancreatic duct lumen in the pancreatic body. The tumor cells had highly atypical nuclei and abundant polymorphic structures, and showed positive staining for granulocyte colony-stimulating factor, which led to the diagnosis of undifferentiated carcinoma. A total of 13 cases of undifferentiated carcinoma with intraductal tumor growth have been reported to date. The case report by Bergmann et al. has been the smallest in histopathological specimen, and the present case is the smallest in size detected by radiological images. Since early undifferentiated carcinoma of the pancreas can resemble those of main-duct intraductal papillary mucinous neoplasm in cross-sectional images, we have to consider undifferentiated carcinoma in the differential diagnosis of the solitary and papillary mass with low contrast enhancement in early phase in the main pancreatic duct.