title: High-grade pancreatic intraepithelial neoplasia in a patient with familial adenomatous polyposis.
abstract: Familial adenomatous polyposis (FAP) is caused by mutation of the adenomatous polyposis coli (APC) gene and is characterized by multiple colorectal adenomas and tumors of other organs and sites. A 58-year-old woman with FAP syndrome and previous total colectomy presented for routine follow-up examination. Abdominal ultrasound and subsequent endoscopic evaluation revealed ampullary and duodenal polyps, as well as inhomogeneity of the pancreatic head. A pancreaticoduodenectomy confirmed multiple duodenal adenomas. In addition, high-grade pancreatic intraepithelial neoplasia (PanIN-3) was found in the smaller pancreatic ducts. Pancreatic precancerous lesions have only rarely been described in FAP, including 2 pancreatic duct adenomas and 2 intraductal papillary mucinous neoplasms. A review of the world English literature revealed no reports of PanIN-3 in association with FAP. Further studies are required to determine if patients with FAP are at increased risk for pancreatic premalignant lesions.
authors.affiliation: Department of Pathology, St John Hospital and Medical Center, Detroit, Michigan, USA. chakgupta@yahoo.com
authors.forename: Chakshu
authors.initials: C
authors.lastname: Gupta
authors.forename: Paul F
authors.initials: PF
authors.lastname: Mazzara
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003082:Colectomy; D004379:Duodenal Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011230:Precancerous Conditions; D014463:Ultrasonography