Pancreatic juice cytology and subclassification of intraductal papillary mucinous neoplasms of the pancreas.
OBJECTIVE
Histological subclassification of intraductal papillary mucinous neoplasms (IPMNs) is important because the malignant potential of each subtype is different. We investigated whether pancreatic juice cytology can be used to define the subtypes of IPMNs preoperatively.


METHODS
The cytological findings and pathological parameters in 19 cases of IPMN were analyzed for correlations. Pancreatic juice cytology specimens were reviewed and classified into 4 types according to the criteria previously described for histological diagnosis: intestinal (Int), gastric foveolar (GF), oncocytic (Onc), and pancreatobiliary (PB), and the resected IPMNs were classified histologically using the same criteria for comparison. Immunochemical testing for MUC proteins was also performed.


RESULTS
In 15 cases (79%), the cytological and histological subclassifications were in agreement. The cytology specimens displayed different features corresponded to their histological subtypes. The sensitivities of the cytological diagnosis of each subtype were 80.0% (Int), 72.7% (GF), and 100% (Onc/PB); and the specificities were 85.7% (Int), 87.5% (GF), and 93.8% (Onc/PB). The cytoplasm of the Int-type cells in the pancreatic juice cytology specimens was positive for MUC2.


CONCLUSIONS
Most of the cytological findings of IPMNs corresponded to the histological findings. The use of MUC2 immunocytochemistry in IPMN subtyping was also demonstrated. Subtyping of IPMNs is useful for preoperative evaluation in addition to cytomorphological grading.
Hibi
Yasuhiro
Y
The Third Department of Surgery, Tokyo Medical University, Nishi-shinjuku, Shinjuku-ku, Tokyo, Japan.
Fukushima
Noriyoshi
N
Tsuchida
Akihiko
A
Sofuni
Atsushi
A
Itoi
Takao
T
Moriyasu
Fuminori
F
Mukai
Kiyoshi
K
Aoki
Tatsuya
T
D002288:Adenocarcinoma, Mucinous / Q000145:classification / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000145:classification / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000145:classification / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism; D046790:Pancreas, Exocrine / Q000378:metabolism / Q000473:pathology; D010183:Pancreatic Ducts / Q000378:metabolism / Q000473:pathology; D010189:Pancreatic Juice / Q000166:cytology*; D010190:Pancreatic Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D012680:Sensitivity and Specificity; D015996:Survival Rate
D009077:Mucins