title: Widespread and multifocal carcinomas in situ (CISs) through almost the entire pancreas: report of a case with preoperative cytological diagnosis.
abstract: OBJECTIVE
  It is imperative for prognostic improvement of pancreatic cancer that we try to diagnose carcinoma in situ (CIS) of lesions, i.e., precursors of invasive ductal carcinomas (IDCs) at an early stage, because results of treatment of patients with IDCs themselves continue to be rather unsatisfactory.
  
  
  RESULTS
  We report here a case of a patient who received subtotal pancreatectomy for widespread and multifocal CISs of the pancreas after preoperative brushing cytology from the epithelium of dilated main pancreatic duct proved cancer-positive preoperatively.
  
  
  CONCLUSIONS
  From our experience, we conclude that examination for CIS of the pancreas must be recommended whenever dilatation of relatively large pancreatic ducts is found by ultrasound or computed tomography. We should therefore advance to magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography and then cytological and/or pathological assessment of the pancreatic duct whenever non-continuous narrowing, localized dilatation, or other irregularities are encountered.
authors.affiliation: Department of Surgery, Cancer Institute of the JFCR, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, 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: Ken
authors.initials: K
authors.lastname: Hayashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Gotoh
authors.forename: Rintaro
authors.initials: R
authors.lastname: Koga
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamada
authors.forename: Masamichi
authors.initials: M
authors.lastname: Katori
authors.forename: Yo
authors.initials: Y
authors.lastname: Kato
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Okamura
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*