scholarly journals Pancreatic Duct Stricture That Rapidly Progressed to Pancreatic Ductal Adenocarcinoma and Formed a Mass within 3 Months: A Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 247-253 ◽  
Author(s):  
Shin Kato ◽  
Kenji Chinen ◽  
Susumu Shinoura ◽  
Fumihito Kunishima
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Pancreatic Carcinoma ◽  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Ductal Adenocarcinoma ◽  
Tubular Adenocarcinoma ◽  
Pancreatic Duct Stricture ◽  
Pancreatic Duct Dilatation ◽  
Duct Stricture

The natural growth rate of pancreatic carcinoma in situ with pancreatic duct stricture remains unclear. Herein, we present a case with pancreatic duct stricture that rapidly grew to form a mass lesion within 3 months. A 74-year-old woman was referred to us for the investigation of a pancreatic duct dilatation. Initial images did not reveal any clear mass lesions near the pancreatic duct stricture. Pancreatic juice cytology showed suspicious findings. Distal pancreatectomy was recommended; however, the patient refused to undergo surgical treatment at that time. Images taken 3 months later demonstrated a nodular pancreatic body mass which was identified as a moderately to poorly differentiated tubular adenocarcinoma. Previous reports have suggested that pancreatic carcinoma in situ and small pancreatic ductal adenocarcinoma require at least 1–2 years to progress to an advanced mass. This case suggests that pancreatic carcinoma in situ may grow rapidly and indicates a need for close follow-up in patients with pancreatic duct strictures, even if the pathological evidence is not confirmed.

scholarly journals A hypoechoic, tumor-like lesion in the pancreatic head and neck on endoscopic ultrasonography may be due to a high-grade pancreatic intraepithelial neoplasia/carcinoma in situ

2021 ◽  
pp. 50
Author(s):  
◽  
◽  
◽  
Keyword(s):  
Head And Neck ◽  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Pancreatic Head ◽  
Intraepithelial Neoplasia ◽  
Ductal Adenocarcinoma ◽  
High Grade ◽  
Pancreatic Intraepithelial Neoplasia ◽  
Cytologic Examination

High-grade pancreatic intraepithelial neoplasia (HG PanIN)/carcinoma in situ (CIS) in the pancreatic body and tail can induce parenchymal atrophy through chronic inflammatory changes presenting as a Hypoechoic area on EUS (Hypocho) or focal pancreatic parenchymal atrophy (FPPA) on computed tomography (CT) and magnetic resonance imaging (MRI). We herein discussed two patients with a hypoechoic area in the pancreatic head and neck on EUS resembling pancreatic ductal adenocarcinoma (PDAC). The lesions consisted of dense fibrosis and fat infiltration with pancreatic parenchymal atrophy around the HG PanIN/CIS in the main pancreatic duct (MPD), which penetrated the lesion and showed mild stenosis and upstream dilation. CT and MRI were unable to visualize the lesions. A specimen was obtained from one lesion by fine-needle aspiration under EUS (EUS-FNA) guidance for histopathological and cytological analysis, but the tests returned negative for adenocarcinoma. However, serial pancreatic-juice aspiration cytologic examination (SPACE) revealed adenocarcinoma in both lesions, prompting surgical resection. Histopathological examination revealed non-invasive HG PanIN/CIS in the MPD surrounded by dense fibrosis and fat deposition in the area of parenchymal atrophy. The CIS was restricted to the area of parenchymal atrophy.These two cases are noteworthy in illustrating a hypoechoic area appearing on EUS as a tumor-like lesion resembling PDAC. EUS-FNA has recently been used histopathologically to diagnose a pancreatic lesion. However, in the present and similar cases, EUS-FNA can only reveal secondary changes due to CIS unless the pancreatic duct covered by the CIS is accidentally punctured. We should bear in mind that CIS can appear as a hypoechoic area resembling PDAC on EUS, and that SPACE is the best method for diagnosing CIS in such cases.

scholarly journals Endoscopic ultrasound findings and pathological features of pancreatic carcinoma in situ

2019 ◽  
Vol 07 (04) ◽  
pp. E585-E593 ◽  
Author(s):  
Yoshihiro Izumi ◽  
Keiji Hanada ◽  
Akihito Okazaki ◽  
Tomoyuki Minami ◽  
Naomichi Hirano ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Pancreatic Duct ◽  
Endoscopic Ultrasound ◽  
Carcinoma In Situ ◽  
Fatty Infiltration ◽  
Pathological Features ◽  
Histological Findings ◽  
Diagnostic Features

Abstract Background and study aims Few studies have evaluated detection of pancreatic carcinoma in situ (PCIS). We evaluated findings of endoscopic ultrasound (EUS) and pathological features of PCIS. Patients and methods We histopathologically studied 16 patients with PCIS following EUS. Diagnostic features evaluated retrospectively included stricture of the main pancreatic duct (MPD) on EUS, presence or absence of hypoechoic areas surrounding the MPD stricture on EUS, the noncancerous part (pancreas of background) on EUS and histopathology, and histological findings adjacent to the area of PCIS. Results On EUS, stricture of the MPD was found in 15 patients (93.8 %). Hypoechoic areas surrounding the MPD stricture were observed in 9 patients (56.3 %), including three (18.8 %) with a 10- to 11-mm hypoechoic mass. EUS findings of the noncancerous part indicated chronic pancreatitis in six patients (37.5 %), pancreatic fatty infiltration in seven (43.8 %), early chronic pancreatitis in two (12.5 %), and normal pancreas in one (6.3 %). Histological findings of the noncancerous part (proximal to the MPD stricture) indicated chronic pancreatitis in 13 patients (81.3 %) and pancreatic fatty infiltration in five patients (31.3 %). Histopathologically, subepithelial inflammatory cell infiltration and fibrosis were present in all 16 patients with PCIS. Conclusions PCIS frequently causes localized changes in inflammation and fibrosis around the pancreatic duct. PCIS often accompanies chronic pancreatitis and pancreatic fatty infiltration in the background of the pancreas. EUS offers sufficient resolution to demonstrate pancreatic changes of PCIS.

Nonfunctioning Pancreatic Endocrine Neoplasm Presenting as Asymptomatic, Isolated Pancreatic Duct Stricture: A Case Report and Review of the Literature

2008 ◽  
Vol 74 (2) ◽  
pp. 168-171
Author(s):  
Anathea C. Powell ◽  
Cristina H. Hajdu ◽  
Alec J. Megibow ◽  
Peter Shamamian
Keyword(s):  
Case Report ◽  
Pancreatic Duct ◽  
Curative Resection ◽  
Review Of The Literature ◽  
Imaging Studies ◽  
Pancreatic Endocrine Neoplasm ◽  
Multiple Imaging ◽  
Pancreatic Duct Stricture ◽  
Pancreatic Duct Dilatation ◽  
Duct Stricture

Morphologic irregularities of the pancreatic duct are often noted on abdominal imaging studies obtained for unrelated symptoms or conditions. We report the case of a patient who was found to have an incidental, isolated pancreatic duct dilatation on multiple imaging studies and who was found to have a nonfunctioning pancreatic endocrine neoplasm at resection. His prognosis is excellent based on the histology of the lesion and a curative resection. This case highlights the importance of fully investigating incidental pancreatic duct abnormalities regardless of the setting in which they are found.

scholarly journals A Case of Intraductal Papillary Mucinous Tumor with Carcinoma In Situ in Branching Pancreatic Duct Apart from Main Lesion

2004 ◽  
Vol 37 (6) ◽  
pp. 686-691 ◽  
Author(s):  
Kiyokazu Hiwatashi ◽  
Mineo Tabata ◽  
Jun Kadono ◽  
Masahiko Osako ◽  
Hiroshi Shibuya ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Carcinoma In Situ ◽  
Intraductal Papillary Mucinous Tumor ◽  
Mucinous Tumor

Tu1358 PILOT STUDY OF DUMBBELL-TYPE COVERED SELF-EXPANDABLE METAL STENT DEPLOYMENT FOR BENIGN PANCREATIC DUCT STRICTURE

2019 ◽  
Vol 89 (6) ◽  
pp. AB589
Author(s):  
Masanori Yamada ◽  
Takeshi Ogura ◽  
Nobu Nishioka ◽  
Akira Miyano ◽  
Rieko Kamiyama ◽  
...  
Keyword(s):  
Pilot Study ◽  
Pancreatic Duct ◽  
Metal Stent ◽  
Stent Deployment ◽  
Pancreatic Duct Stricture ◽  
Duct Stricture ◽  
Self Expandable Metal Stent

scholarly journals An example of refractory pancreatic duct stricture treated with the Soehendra stent retriever

Suizo ◽  
2008 ◽  
Vol 23 (1) ◽  
pp. 83-88
Author(s):  
Masakuni FUJII ◽  
Hirofumi KAWAMOTO ◽  
Ryo HARADA ◽  
Koichiro TSUTSUMI ◽  
Naoko KURIHARA ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Stent Retriever ◽  
Pancreatic Duct Stricture ◽  
Duct Stricture
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