[Clinicopathologic analysis of 92 cases of pancreatic cystic neoplasm].
OBJECTIVE
To study the clinicopathologic and immunohistochemical features of cystic neoplasms of the pancreas.


METHODS
Ninety-two cases of cystic neoplasm of pancreas were retrieved from the Department archival file during the period from 1999 to 2005. Histologic features were studied and the tumors were typed according to WHO classification. Immunohistochemistry was also carried out using paraffin-embedded tissues.


RESULTS
The age of patients ranged from 16 to 80 years. The patients included 33 males and 59 females. The tumors varied from 2 cm to 21 cm in diameter. They consisted of intraductal papillary mucinous neoplasm (36/92), serous cystic neoplasm (18/92), solid pseudopapillary tumor (18/92), mucinous cystic neoplasm (14/92), cystic pancreatic ductal adenocarcinoma (4/92) and cystic pancreatic endocrine neoplasm (2/92). Immunohistochemical study revealed variable staining patterns, with frequent overlaps between different tumor types. In general, serous cystic neoplasm expressed MUC1, while mucinous cystic neoplasm was positive for MUC-5AC, intraductal papillary mucinous neoplasm for MUC-2 and cystic pancreatic ductal adenocarcinoma for MUC-1. On the other hand, solid pseudopapillary tumor expressed alpha-antitrypsin, alpha-antichymotrypsin, vimentin and progesterone receptor.


CONCLUSIONS
Accurate diagnosis of pancreatic cystic neoplasms requires correlation of clinical findings, radiologic examination, histologic features and immunostaining results. Pathologic distinction is important because of different prognostic significance. Two-thirds of pancreatic cystic neoplasms are premalignant or malignant and warrant surgical resection, whereas the remaining one-third (including pseudocyst and serous cystadenoma) are benign and can be treated conservatively.
Ji
Yuan
Y
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. yji@zshospital.com
Zhu
Xiong-zeng
XZ
Lou
Wen-hui
WH
Wang
Dong-qing
DQ
Jin
Da-yong
DY
Zeng
Meng-su
MS
Zeng
Hai-ying
HY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000473:pathology; D018282:Cystadenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000473:pathology; D018291:Cystadenoma, Mucinous / Q000378:metabolism / Q000473:pathology; D018293:Cystadenoma, Serous / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC / Q000378:metabolism; D018396:Mucin-1 / Q000378:metabolism*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000378:metabolism / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
C060192:MUC1 protein, human; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D018396:Mucin-1