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WHO Classification of Tumours
Intraductal tubulopapillary neoplasm (ITPN)
Pancreas


Definition

An intraductal, grossly visible, tubule-forming epithelial neoplasm with high-grade dysplasia and ductal differentiation without overt production of mucin 1
Klimstra DS, Adsay NV, Dhall D, Shimizu M, Cymes K, Basturk O et al (2007). Intraductal tubular carcinoma of the pancreas: clinicopathologic and immunohistochemical analysis of 18 cases. Mod Pathol 20: 285A-


Click to access Pubmed
Suda K, Hirai S, Matsumoto Y, Mogaki M, Oyama T, Mitsui T, Fujibayashi M, Kumazawa K, Kajiwara T (1996)
Variant of intraductal carcinoma (with scant mucin production) is of main pancreatic duct origin: a clinicopathological study of four patients.
Am J Gastroenterol 91: 798-800




Click to access Pubmed
Tajiri T, Tate G, Inagaki T, Kunimura T, Inoue K, Mitsuya T, Yoshiba M, Morohoshi T (2005)
Intraductal tubular neoplasms of the pancreas: histogenesis and differentiation.
Pancreas 30: 115-21




Click to access Pubmed
Yamaguchi H, Shimizu M, Ban S, Koyama I, Hatori T, Fujita I, Yamamoto M, Kawamura S, Kobayashi M, Ishida K, Morikawa T, Motoi F, Unno M, Kanno A, Satoh K, Shimosegawa T, Orikasa H, Watanabe T, Nishimura K, Ebihara Y, Koike N, Furukawa T (2009)
Intraductal tubulopapillary neoplasms of the pancreas distinct from pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms.
Am J Surg Pathol 33: 1164-72



. Focal tubulopapillary growth may be seen. If there is a component of invasive carcinoma, the lesions are designated “intraductal tubulopapillary neoplasm with an associated invasive carcinoma”. These tumours are rare. Patients present with nonspecific symptoms. These tumours are composed of nodules of back-to-back tubular glands with occasional papillary elements, resulting in large cribriformed structures within dilated pancreatic ducts 2
Klimstra DS, Adsay NV, Dhall D, Shimizu M, Cymes K, Basturk O et al (2007). Intraductal tubular carcinoma of the pancreas: clinicopathologic and immunohistochemical analysis of 18 cases. Mod Pathol 20: 285A-


Click to access Pubmed
Tajiri T, Tate G, Inagaki T, Kunimura T, Inoue K, Mitsuya T, Yoshiba M, Morohoshi T (2005)
Intraductal tubular neoplasms of the pancreas: histogenesis and differentiation.
Pancreas 30: 115-21




Click to access Pubmed
Yamaguchi H, Shimizu M, Ban S, Koyama I, Hatori T, Fujita I, Yamamoto M, Kawamura S, Kobayashi M, Ishida K, Morikawa T, Motoi F, Unno M, Kanno A, Satoh K, Shimosegawa T, Orikasa H, Watanabe T, Nishimura K, Ebihara Y, Koike N, Furukawa T (2009)
Intraductal tubulopapillary neoplasms of the pancreas distinct from pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms.
Am J Surg Pathol 33: 1164-72



. Mucin is usually not seen. The limited data in the literature regarding the prognosis for patients suggest that these neoplasms are relatively indolent neoplasms, with a prognosis that is significantly better than that of infiltrating ductal adenocarcinoma of the pancreas 3
Klimstra DS, Adsay NV, Dhall D, Shimizu M, Cymes K, Basturk O et al (2007). Intraductal tubular carcinoma of the pancreas: clinicopathologic and immunohistochemical analysis of 18 cases. Mod Pathol 20: 285A-


Click to access Pubmed
Suda K, Hirai S, Matsumoto Y, Mogaki M, Oyama T, Mitsui T, Fujibayashi M, Kumazawa K, Kajiwara T (1996)
Variant of intraductal carcinoma (with scant mucin production) is of main pancreatic duct origin: a clinicopathological study of four patients.
Am J Gastroenterol 91: 798-800




Click to access Pubmed
Tajiri T, Tate G, Inagaki T, Kunimura T, Inoue K, Mitsuya T, Yoshiba M, Morohoshi T (2005)
Intraductal tubular neoplasms of the pancreas: histogenesis and differentiation.
Pancreas 30: 115-21




Click to access Pubmed
Yamaguchi H, Shimizu M, Ban S, Koyama I, Hatori T, Fujita I, Yamamoto M, Kawamura S, Kobayashi M, Ishida K, Morikawa T, Motoi F, Unno M, Kanno A, Satoh K, Shimosegawa T, Orikasa H, Watanabe T, Nishimura K, Ebihara Y, Koike N, Furukawa T (2009)
Intraductal tubulopapillary neoplasms of the pancreas distinct from pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms.
Am J Surg Pathol 33: 1164-72



. Survival beyond 5 years is noted in more than a third of the patients reported 4
Klimstra DS, Adsay NV, Dhall D, Shimizu M, Cymes K, Basturk O et al (2007). Intraductal tubular carcinoma of the pancreas: clinicopathologic and immunohistochemical analysis of 18 cases. Mod Pathol 20: 285A-


Click for details
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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Commentary: Preneoplastic lesions of the digestive system