[Intraductal papillary mucinous XXXX : a clinicopathologic and immunohistochemical study of 19 cases].

@entity1 @entity788 @entity4929 @entity353 @entity6 @entity1087 @entity5 @entity986 @entity876 @entity158 @entity1722
OBJECTIVE: To study the clinicopathologic features and diagnosis of @entity4929 ( @entity4929 ) of the pancreas. METHODS: Nineteen cases of @entity4929 encountered during the period from 1999 to 2007 were studied by light microscopy and immunohistochemistry. RESULTS: @entity4929 occurred more often in males (68%). It affected @entity1 in older age group (mean age = 59) and was located mainly in the head of pancreas (60%). The mean @entity5 size was 4.2 cm (range = 1 to 8 cm). The clinical presentation was @entity158 (53%), @entity353 (32%), @entity6 (21%), @entity788 (21%) and @entity1087 (10%). Pancreatectomy was performed in 18 cases. The remaining @entity1 received bypass surgery only. Features of in-situ or invasive @entity5 were present in 15 of the 19 cases (78%). Histologically, the @entity5 consisted of papillary proliferations protruding into and expanding the pancreatic ducts. Invasion into the surrounding pancreatic parenchyma was noted in 12 cases and chronic @entity788 was present in 16 cases. Follow-up data (4 to 48 months) were available in 13 @entity1 . Apart from 1 @entity1 who died of other disease, all were still alive. Immunohistochemical study showed that @entity876 was positive in 6 cases, @entity986 in 5 cases and fascin in 8 cases. The expression of @entity1722 was all negative. Ki-67 index ranged from 1% to 80% (mean = 38%). CONCLUSIONS: Malignant changes are not uncommon in @entity4929 . The prognosis after surgical resection however is better than that of conventional @entity788 . The overexpression of @entity876 , @entity986 and fascin may be related to @entity5 progression. The possibility of malignant transformation needs to be considered if the Ki-67 index is over 15%. Early recognition by radiologic examination (including ERCP) and pancreatic cytology would be helpful in early diagnosis. Surgical resection represents the mainstay of treatment and long-term post-operative follow up is needed.
