Difference between revisions of "Pancreas"

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Pancreas (view source)

Revision as of 04:27, 21 May 2016

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→‎Pancreatic intraepithelial neoplasia: split out
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=Pre-malignant lesions=
=Pre-malignant lesions=
==Pancreatic intraepithelial neoplasia==
==Pancreatic intraepithelial neoplasia==
*Abbreviated ''PanIN''.
*Abbreviated ''PanIN''.
 
{{Main|Pancreatic intraepithelial neoplasia}}
===General===
*PanIN is thought to be the precursor lesion for pancreatic carcinoma.<ref name=Ref_PBoD949>{{Ref PBoD|949}}</ref>
 
====Overview====
Putative preneoplasm-neoplasm-carcinoma sequence:
*PanIN1a.
**Not neoplastic, i.e. clonal.
*PanIN1b.
**Not neoplastic, i.e. clonal.
*PanIN2.
**Can be thought of as ''low-grade dysplasia'', e.g. a ''(colonic) [[tubular adenoma of the gastrointestinal tract|tubular adenoma]] without high-grade dysplasia''.
*PanIN3.
**Can be thought of as ''high-grade dysplasia'', e.g. ''(colonic) villous adenoma''.
**May be referred to as ''carcinoma in situ''.<ref name=pmid21537863>{{Cite journal  | last1 = Matthaei | first1 = H. | last2 = Hong | first2 = SM. | last3 = Mayo | first3 = SC. | last4 = dal Molin | first4 = M. | last5 = Olino | first5 = K. | last6 = Venkat | first6 = R. | last7 = Goggins | first7 = M. | last8 = Herman | first8 = JM. | last9 = Edil | first9 = BH. | title = Presence of pancreatic intraepithelial neoplasia in the pancreatic transection margin does not influence outcome in patients with R0 resected pancreatic cancer. | journal = Ann Surg Oncol | volume = 18 | issue = 12 | pages = 3493-9 | month = Nov | year = 2011 | doi = 10.1245/s10434-011-1745-9 | PMID = 21537863 }}</ref>
 
===Microscopic===
Features:<ref name=Ref_PBoD949>{{Ref PBoD|949}}</ref>
*PanIN1a - increased amount of cytoplasm.
**Nuclear size & stratification perserved, arch. perserved.
*PanIN1b - increased amount of cytoplasm, folding of epithelium/moderated arch. distortion.
**Nuclear size & stratification perserved.
*PanIN2 - increased cell size, and nuclear enlargement (increased NC ratio), moderate nuclear atypia with loss of (basal) nuclear polarization.
*PanIN3 - marked nuclear atypia with increased NC ratio.
**No invasion identified.
*Pancreatic carcinoma - cytologic features of PanIN3 with definite invasion.
 
====Images====
<gallery>
Image:Pancreas_neoplasia_carcinoma_sequence.png | Normal pancreas, pancreatic intraepithelial neoplasia and pancreatic carcinoma. (WC)
</gallery>
www:
*[http://www.path.jhu.edu/pancreas/professionals/panin-3.php PanIN III - several images (jhu.edu)].


=Solid tumours=
=Solid tumours=
Michael
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