Pancreatic juice cytology in IPMN of the pancreas.
BACKGROUND
Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a disease ranging from adenoma to borderline (with moderate dysplasia) and further to carcinoma (noninvasive and invasive) and surgical strategy is different by the grades of dysplasia.


METHODS
Preoperative pancreatic juice cytology in IPMN was reviewed in 71 patients with IPMN who underwent surgical resection.


RESULTS
The IPMN was adenoma in 48 patients, borderline in 13 and carcinoma (invasive) in 10. The sensitivity of pancreatic juice cytology in malignant IPMN was 40% (4/10). In 4 patients with the 48 IPM adenomas, diagnosis of pancreatic juice cytology was class IV or V. One of the 4 cases was considered to be an overdiagnosis of cytology, but the other 3 cases were considered to be a consequence of accompanying carcinoma in situ (or PanIN-3) (2 patients) or invasive ductal adenocarcinoma (1 patient) apart from IPMN. Sensitivity of pancreatic juice cytology was higher in IPMN of the main duct type with mucin hypersecretion and with mural nodules.


CONCLUSIONS
These findings suggest that pancreatic juice cytology in IPMN is useful especially in the main duct type with mucin hypersecretion and mural nodules. When the diagnosis of pancreatic juice cytology is malignant in otherwise benign-looking IPMNs, coexistence of pancreatic carcinoma should be suspected.
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. yamaguch@surg1.med.kyush-n.ac.jp
Koji
K
Yamaguchi
Masafumi
M
Nakamura
Kengo
K
Shirahane
Masahiko
M
Kawamoto
Hiroyuki
H
Konomi
Masayukii
M
Ohta
Masao
M
Tanaka
D002288:Adenocarcinoma, Mucinous / Q000145:classification / Q000175:diagnosis*; D000236:Adenoma / Q000145:classification / Q000175:diagnosis; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification / Q000175:diagnosis*; D002291:Carcinoma, Papillary / Q000145:classification / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010189:Pancreatic Juice / Q000166:cytology*; D010190:Pancreatic Neoplasms / Q000145:classification / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity