Pancreatogram findings for carcinoma in situ (CIS) of the pancreas seen on endoscopic retrograde cholangiopancreatography and postoperative pancreatography of resected specimens: can CIS be diagnosed preoperatively?
OBJECTIVE
From 1992 to 2003, 7 carcinomata in situ (CIS) were incidentally discovered during microscopical observation of resected materials for advanced carcinomas of peripancreatic organs, of which 4 had undergone endoscopic retrograde cholangiopancreatography (ERCP) or postoperative pancreatography of the resected specimen (POP). In addition, 7 of 79 invasive ductal carcinomata (IDC) of the pancreas were accompanied by CIS > or =2 cm long. A total of 11 patients were reviewed here for pancreatographic findings for CIS of the pancreas.


METHODS
All resected pancreatobiliary materials were sliced serially at 5- to 8-mm intervals in a plane at right angles to the main pancreatic duct, referring to POP images.


RESULTS
Irregularity (I), non-continuous narrowing (N), granular defects (G), and dilatation (D) were seen in 78, 67, 33 and 22% on ERCP, respectively, and in 90, 70, 60 and 40% on POP, respectively.


CONCLUSIONS
I, N, G, and D are most important pancreatographic findings in ERCP and highly suggestive of CIS of the pancreas, so that whenever they are encountered, cytological and/or pathological examination of the pancreatic duct should be actively performed.
Seki
Makoto
M
Department of Surgery, Cancer Institute of the JFCR, Tokyo, Japan. makoto.seki@jfcr.or.jp
Ninomiya
Eiji
E
Takano
Koichi
K
Fujita
Rikiya
R
Aruga
Akiko
A
Yamada
Keiko
K
Tanaka
Hiroko
H
Matsueda
Kiyoshi
K
Mikami
Kazuhisa
K
Hiki
Naoki
N
Saiura
Akio
A
Yamamoto
Junji
J
Yamaguchi
Toshiharu
T
Yanagisawa
Akio
A
Ikeda
Masaki
M
Sasaki
Keiko
K
Kato
Yo
Y
D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care