Intraductal papillary mucinous neoplasm (IPMN) with low- or intermediate-grade dysplasia

Intraductal papillary mucinous neoplasm (IPMN) with low- or intermediate-grade dysplasia
Pancreas

Definition

An intraductal benign epithelial neoplasm arising from the main pancreatic duct or its major branches. Signs and symptoms include epigastric pain, weight loss, jaundice, diabetes, and pancreatitis. It is composed of columnar mucin-containing cells which line dilated ducts and form papillary or pseudopapillary structures. Dysplastic changes in the columnar cells are minimal or absent. The prognosis is usually favourable.

Proposed definition:
Intraductal papillary mucinous neoplasms (IPMNs) are intraductal grossly-visible (typically ≥ 1.0 cm) epithelial neoplasms of mucin producing cells, arising in the main pancreatic duct or its branches

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Hruban RH, Takaori K, Klimstra DS, Adsay NV, Albores-Saavedra J, Biankin AV, Biankin SA, Compton C, Fukushima N, Furukawa T, Goggins M, Kato Y, Kloppel G, Longnecker DS, Lüttges J, Maitra A, Offerhaus GJ, Shimizu M, Yonezawa S (2004)
An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms.
Am J Surg Pathol 28: 977-87

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Tanaka M, Chari S, Adsay V, Fernandez-del Castillo C, Falconi M, Shimizu M, Yamaguchi K, Yamao K, Matsuno S, (2006)
International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas.
Pancreatology 6: 17-32

. Signs and symptoms include epigastric pain, weight loss, jaundice, diabetes, and pancreatitis. The neoplastic epithelium is usually papillary, and the degrees of mucin secretion, duct dilatation (cyst formation), and dysplasia are variable. IPMNs are classified on the basis of the highest degree of cytoarchitectural atypia and invasiveness as:
> IPMN with low- to intermediate-grade of dysplasia, previously called intraductal papillary-mucinous adenoma
> IPMN with high grade of dysplasia , previously called intraductal papillary-mucinous carcinoma, non-invasive
> IPMN with an associated invasive carcinoma if there is a component of invasive carcinoma.

In case of IPMN with low- to intermediate-grade of dysplasia, dysplastic changes in the columnar cells are minimal or absent. The prognosis is usually favourable.

Commentary: Preneoplastic lesions of the digestive system