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Experimental and Therapeutic Medicine Jul 2022Epithelial tumors that originate from the kidney are uncommon. The majority of cases reported in the literature are malignant, with <1% of adenocarcinomas. Adenomas are...
Epithelial tumors that originate from the kidney are uncommon. The majority of cases reported in the literature are malignant, with <1% of adenocarcinomas. Adenomas are even rarer. A case of mucinous cystadenoma of the kidney was diagnosed and treated in Cangzhou Hospital of Integrated TCM-WM•HEBEI. The clinical feature of this disease was atypical. The principal symptom of mucinous cystadenoma of the kidney was a lump in the upper abdomen with intermittent pain in the abdomen. The tumor size ranged from 5-12 cm. The patient was clinically diagnosed with multiple renal cysts with thickened walls and hemorrhage. The patient was admitted to the hospital five days later, and a left nephrectomy was performed. The tumor capsule was integrated and did not adhere to the adjacent tissue. One or multiple smooth-walled dilated cystic areas were found on the cut section, some of which were filled with grey opaque gelatinous clots. Under light microscopy, the epithelial lining was characterized by a single layer of columnar with papillary proliferation and almost had no mitosis. Immunohistochemistry showed that the cyst was positive for carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA). Following nephrectomy, the patient was followed up for 8 years and no recurrence and metastasis were found. A total of five articles were retrieved, including six cases with mucinous cystadenoma of the kidney. The clinical feature of this disease was atypical, making clinical diagnosis difficult. Histopathological examination revealed that the cyst consisted of mucinous epithelium with supporting fibrous tissue and immunohistochemistry showed that the cyst was positive for CEA and PCNA. Patients with all resection of the affected kidney had an improved prognosis.
PubMed: 35720631
DOI: 10.3892/etm.2022.11378 -
Annals of Gastroenterology 2016Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple... (Review)
Review
Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple retention cysts, pseudocysts and cystic neoplasms. Mucinous cystic neoplasm is a frequent type of cystic neoplasm and has a malignant potential. Serous cystadenoma follows in frequency and is usually benign. Intraductal papillary mucinous neoplasms are the most commonly resected cystic pancreatic neoplasms characterized by dilated segments of the main pancreatic duct and/or side branches, the wall of which is covered by mucus secreting cells. These neoplasms can occupy the pancreatic head or any part of the organ. Solid pseudopapillary tumor is rare, has a low tendency for malignancy, and is usually located in the pancreatic body or tail. Endoscopic ultrasound with the use of fine-needle aspiration and cytology permits discrimination of those lesions. In this review, the main characteristics of those lesions are presented, as well as recommendations regarding their follow up and management according to recent guidelines.
PubMed: 27065727
DOI: 10.20524/aog.2016.0007 -
Revista Espanola de Enfermedades... May 2017The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is... (Review)
Review
The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is mandatory to develop a strategy to clearly discriminate those cysts with a potential for malignant transformation from those that do not carry any significant risk. Intraductal papillary mucinous neoplasms and mucinous cystadenomas are mucinous cystic neoplasms with a known malignant potential that have gained greater recognition in recent years. However, despite the numerous studies that have been carried out, their differential diagnosis among other cysts subtypes and their therapeutic approach continue to be a challenge for clinicians. This review contains a critical approach of the current recommendations and management strategies regarding intraductal papillary mucinous neoplasms and mucinous cystadenomas, as well as highlighting the limitations exposed in current guidelines.
Topics: Cystadenoma, Mucinous; Diagnosis, Differential; Humans; Pancreatic Neoplasms; Practice Guidelines as Topic; Prognosis
PubMed: 28112959
DOI: 10.17235/reed.2017.4630/2016 -
Annals of Gastroenterological Surgery Jun 2017Mucinous cholangiocarcinoma is extremely rare and its clinicopathological features remain unclear. The present study aimed to analyze published data on mucinous... (Review)
Review
Mucinous cholangiocarcinoma is extremely rare and its clinicopathological features remain unclear. The present study aimed to analyze published data on mucinous cholangiocarcinoma. Medical databases were searched from 1980 to 2016, and clinicopathological data for 16 mucinous cholangiocarcinoma patients were obtained. Characteristic imaging findings, including hypovascular tumor with peripheral enhancement on computed tomography and angiography, extremely high intensity on T2-weighted magnetic resonance images, intratumoral calcification and luminal communication between the tumor and bile duct on cholangiography, were noted. Mucinous cholangiocarcinoma was correctly diagnosed in one patient only, with some patients diagnosed as low-malignant biliary cystic tumors preoperatively. Five cases were followed up after the first medical examination, and three of these were initially diagnosed as biliary cystadenoma or intraductal papillary neoplasm of the bile duct. All five tumors showed marked enlargement within 4 months of follow up. Macroscopically, the resected tumors were non-cystic/solid in seven cases, and cystic in seven. Tumor diameter ranged from 5 cm to 22 cm, and mucoid cut surface, lobulation, lack of capsule and papillary growth were observed. Microscopically, co-existing intraductal papillary neoplasm of the bile duct was noted in three of five patients with available data. Nine of 10 cases in whom the pathological stage was reported had advanced disease with lymph node and/or distant metastasis, and 5-year survival was achieved in one microinvasive case only. Overall 1- and 3-year survival rates were 60.1% and 40.1%, respectively. The possibility of mucinous cholangiocarcinoma should be considered when biliary cystic tumors are detected on imaging modalities, despite the rarity of this tumor.
PubMed: 29863172
DOI: 10.1002/ags3.12016 -
Digestive Diseases and Sciences May 2022Andrew Canakis. (Review)
Review
Andrew Canakis.
Topics: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Pancreatic Cyst; Pancreatic Neoplasms
PubMed: 34383196
DOI: 10.1007/s10620-021-07084-1 -
Visceral Medicine Jul 2018Pancreatic cystic lesions are being detected with increasing frequency because of increased use and improved quality of cross-sectional imaging techniques. Pancreatic... (Review)
Review
Pancreatic cystic lesions are being detected with increasing frequency because of increased use and improved quality of cross-sectional imaging techniques. Pancreatic cystic lesions encompass non-neoplastic lesions (such as pancreatitis-related collections) and neoplastic tumors. Common cystic pancreatic neoplasms include serous cystadenomas, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, and solid pseudopapillary tumors. These cystic pancreatic neoplasms may have typical morphology, but at times show overlapping imaging features on cross-sectional examinations. This article reviews the classical and atypical imaging features of commonly encountered cystic pancreatic neoplasms and presents the limitations of current cross-sectional imaging techniques in accurately classifying pancreatic cystic lesions.
PubMed: 30140683
DOI: 10.1159/000489674 -
Archives of Pathology & Laboratory... Mar 2022Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic...
CONTEXT.—
Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic ultrasound/computed tomography/magnetic resonance imaging-guided fine-needle aspiration biopsies from these lesions have become an integral part of pathologists' daily practice. Because patient management has become increasingly conservative, accurate preoperative diagnosis is critical. Cytologic distinction of low-risk (pseudocysts, serous cystadenoma, lymphoepithelial cysts, and squamoid cysts of the pancreatic duct) from high-risk pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) requires incorporation of clinical, radiologic, and cytologic findings, in conjunction with chemical and molecular analysis of cyst fluid. Cytopathologists must ensure appropriate specimen triage, along with cytologic interpretation, cyst classification, and even grading of some (mucinous) cysts. Epithelial atypia in mucinous cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) has transitioned from a 3-tiered to a 2-tiered classification system, and intraductal oncocytic papillary neoplasms and intraductal tubulopapillary neoplasms have been separately reclassified because of their distinctive clinicopathologic characteristics. Because these lesions may be sampled on brushing or fine-needle aspiration biopsy, knowledge of their cytomorphology is critical.
OBJECTIVE.—
To use an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions (incorporating clinical, radiologic, and cytologic findings with [chemical/molecular] cyst fluid analysis and ancillary stains) for definitive diagnosis and classification.
DATA SOURCES.—
Review of current literature on the cytopathology of cystic/intraductal pancreatobiliary tract lesions.
CONCLUSIONS.—
Our knowledge/understanding of recent updates in cystic/intraductal pancreatobiliary lesions can ensure that cytopathologists appropriately triage specimens, judiciously use and interpret ancillary studies, and incorporate the studies into reporting.
Topics: Cystadenoma, Serous; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Magnetic Resonance Imaging; Pancreatic Cyst; Pancreatic Neoplasms
PubMed: 33836534
DOI: 10.5858/arpa.2020-0553-RA -
North American Journal of Medical... Aug 2014Cystic neoplasms of the pancreas are rare and constitute approximately 0.5% of all pancreatic neoplasms.
BACKGROUND
Cystic neoplasms of the pancreas are rare and constitute approximately 0.5% of all pancreatic neoplasms.
AIMS
The study was to describe clinicopathological features of pancreatic cystic tumors.
PATIENTS AND METHODS
In our retrospective study, we reviewed 10 cases of pancreatic cystic neoplasms that were diagnosed at the pathology department of Mongi Slim hospital over a 14-year period (2000-2013). We adopted the latest World Health Organization (WHO) classification (2010) in grouping all tumors.
RESULTS
There were one male and nine female patients (sex ratio M/F = 1:9) aged between 21 and 68 years (mean = 37.5 years). The most common clinical presentation was epigastric and abdominal pain (n = 6) followed by vomiting (n = 3). Abdominal computed tomography (CT) scan disclosed a cystic lesion of the pancreas ranging in size between 2 and 10 cm (mean = 6.75 cm). All patients underwent surgical treatment. Histopathological examination of the surgical specimen established the diagnosis of solid pseudopapillary neoplasm (n = 2), serous cystic neoplasm (n = 2), mucinous cystadenoma (n = 4), mucinous cystadenocarcinoma (n = 1), and intraductal papillary mucinous neoplasm with invasive carcinoma (n = 1).
CONCLUSION
Better understanding of pancreatic cystic neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.
PubMed: 25210676
DOI: 10.4103/1947-2714.139298 -
World Journal of Gastroenterology Jan 2016The approach to incidentally noted pancreatic cysts is constantly evolving. While surgical resection is indicated for malignant or higher risk cysts, correctly... (Review)
Review
The approach to incidentally noted pancreatic cysts is constantly evolving. While surgical resection is indicated for malignant or higher risk cysts, correctly identifying these highest risk pancreatic cystic lesions remains difficult. Using parameters including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines have sought to identify the higher risk patients who would benefit from further evaluation using endoscopic ultrasound (EUS). Not only can EUS help further assess the presence of solid component and nodules, but also fine needle aspiration of cyst fluid aids in diagnosis by obtaining cellular, molecular, and genetic data. The impact of new endoscopic innovations with novel methods of direct visualization including confocal endomicroscopy require further validation. This review also highlights the differences between the 2012 IAP and 2015 AGA guidelines, which include the thresholds for sending patients for EUS and surgery and methods, interval, and duration of surveillance for unresected cysts.
Topics: Cholangiopancreatography, Magnetic Resonance; Diagnosis, Differential; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Incidental Findings; Microscopy, Confocal; Neoplasms, Cystic, Mucinous, and Serous; Pancreatectomy; Pancreatic Cyst; Pancreatic Neoplasms; Practice Guidelines as Topic; Predictive Value of Tests; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 26811661
DOI: 10.3748/wjg.v22.i3.1236 -
Surgical Pathology Clinics Dec 2016Pancreatic cysts are extremely common, and are identified in between 2% to 13% on abdominal imaging studies. Most pancreatic cysts are pseudocysts, serous cystic... (Review)
Review
Pancreatic cysts are extremely common, and are identified in between 2% to 13% on abdominal imaging studies. Most pancreatic cysts are pseudocysts, serous cystic neoplasms, mucinous cystic neoplasms, or intraductal papillary mucinous neoplasms. The management of pancreatic cysts depends on whether a cyst is benign, has malignant potential, or harbors high-grade dysplasia or invasive carcinoma. The diagnosis of pancreatic cysts, and assessment of risk of malignant transformation, incorporates clinical history, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound, and fine-needle aspiration of cyst fluid. This article reviews the cyst fluid markers that are currently used, as well as promising markers under development.
Topics: Antigens, Tumor-Associated, Carbohydrate; Carcinoembryonic Antigen; Cyst Fluid; Diagnosis, Differential; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Magnetic Resonance Imaging; Pancreas; Pancreatic Cyst; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 27926366
DOI: 10.1016/j.path.2016.05.010