title: 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?
abstract: 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.
authors.affiliation: Department of Surgery, Cancer Institute of the JFCR, Tokyo, Japan. makoto.seki@jfcr.or.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Eiji
authors.initials: E
authors.lastname: Ninomiya
authors.forename: Koichi
authors.initials: K
authors.lastname: Takano
authors.forename: Rikiya
authors.initials: R
authors.lastname: Fujita
authors.forename: Akiko
authors.initials: A
authors.lastname: Aruga
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamada
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Matsueda
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Mikami
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiki
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Ikeda
authors.forename: Keiko
authors.initials: K
authors.lastname: Sasaki
authors.forename: Yo
authors.initials: Y
authors.lastname: Kato
mesh_terms: 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