Difference between revisions of "Solid pseudopapillary tumour"

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#redirect [[Pancreas#Solid pseudopapillary tumour]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Solid_pseudopapillary_tumour_-_high_mag.jpg
| Width      =
| Caption    = Solid pseudopapillary tumour. [[H&E stain]].
| Synonyms  = solid pseudopapillary neoplasm, solid and papillary epithelial neoplasm
| Micro      = solid sheets of cells - focally dyscohesive, eosinophilic cytoplasm (occasionally clear), focal eosinophilic (intracytoplasmic) globules, uniform nuclei with occasional nuclear grooves, +/-necrosis (creating spaces/cavities), +/-cholesterol clefts
| Subtypes  =
| LMDDx      = [[pancreatic pseudocyst]], cystadenoma, cystadenocarcinoma (see [[invasive ductal carcinoma of the pancreas]]), [[pancreatic neuroendocrine tumour]]
| Stains    =
| IHC        = PR +ve, CD10 +ve, beta-catenin +ve, chromogranin -ve, synaptophysin +ve (weak)
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[pancreas]] - usually tail
| Assdx      =
| Syndromes  =
| Clinicalhx = typical young (20s or 30s), women (M:F = 1:9)
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = usu. benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Solid pseudopapillary tumour''' is a [[pancreas|pancreatic]] tumour that is usually found in the tail.
 
It is also known as '''solid pseudopapillary neoplasm''' (abbreviation '''SPN''') and '''solid and papillary epithelial neoplasm''' (abbreviated '''SPEN''').<ref>URL: [http://brighamrad.harvard.edu/Cases/bwh/hcache/360/full.html http://brighamrad.harvard.edu/Cases/bwh/hcache/360/full.html]. Accessed on: 31 October 2011.</ref>
 
==General==
*Obscure cell of origin.
*Considered low grade, i.e. prognosis is usually good.
 
===Epidemiology===
Features:<ref name=Ref_GLP493>{{Ref GLP|493}}</ref>
*Usually females (M:F=1:9).
*Mean age of presentation third decade (20s).
 
===Management===
May be followed radiologically.
 
==Microscopic==
Features:<ref>{{Ref GLP|493-5}}</ref>
*Solid sheets of cells, focally dyscohesive.
*Eosinophilic cytoplasm.
**Occasionally clear cytoplasm.<ref name=pmid18708424>{{cite journal |author=Serra S, Chetty R |title=Revision 2: an immunohistochemical approach and evaluation of solid pseudopapillary tumour of the pancreas |journal=J. Clin. Pathol. |volume=61 |issue=11 |pages=1153–9 |year=2008 |month=November |pmid=18708424 |doi=10.1136/jcp.2008.057828 |url=http://jcp.bmj.com/content/61/11/1153}}</ref>
**Focal eosinophilic (intracytoplasmic) globules - '''key feature'''.
*Uniform nuclei with occasional nuclear grooves.
*+/-Necrosis - creating spaces/cavities.
*+/-Cholesterol clefts.<ref name=pmid19156179>{{Cite journal  | last1 = Abad Licham | first1 = M. | last2 = Sanchez Lihon | first2 = J. | last3 = Celis Zapata | first3 = J. | title = [Pseudopapillary solid tumor of pancreas in the INEN]. | journal = Rev Gastroenterol Peru | volume = 28 | issue = 4 | pages = 356-61 | month =  | year =  | doi =  | PMID = 19156179 }}</ref>
 
DDx:
*[[Pancreatic pseudocyst]].
*Cystadenoma.
*Cystadenocarcinoma - see [[invasive ductal carcinoma of the pancreas]].
*[[Pancreatic neuroendocrine tumour]] - may have cytoplasmic vacuolation, [[hyaline globules]].<ref name=pmid18708424/>
 
===Images===
<gallery>
Image:Solid_pseudopapillary_tumour_-_very_low_mag.jpg | SPT - very low mag. (WC)
Image:Solid_pseudopapillary_tumour_-_low_mag.jpg | SPT - low mag. (WC)
Image:Solid_pseudopapillary_tumour_-_intermed_mag.jpg | SPT - intermed. mag. (WC)
Image:Solid_pseudopapillary_tumour_-_high_mag.jpg | SPT - high mag. (WC)
Image:Solid_pseudopapillary_tumour_-_very_high_mag.jpg | SPT - very high mag. (WC)
</gallery>
www:
*[http://jcp.bmj.com/content/61/11/1153/F1.large.jpg Solid pseudopapillary tumour (bmj.com)].
[[File: PANC solid pseudo 1 sl 1.png| Solid-pseudopapillary neoplasm of pancreas]]
[[File: PANC solid pseudo 1 sl 2.png| Solid-pseudopapillary neoplasm of pancreas]]
[[File: PANC solid pseudo 1 sl 3.png| Solid-pseudopapillary neoplasm of pancreas]]
[[File: PANC solid pseudo 1 sl 4.png| Solid-pseudopapillary neoplasm of pancreas]]
[[File: PANC solid pseudo 1 sl 5.png| Solid-pseudopapillary neoplasm of pancreas]]
[[File: PANC solid pseudo 1 sl 6.png| Solid-pseudopapillary neoplasm of pancreas]]
 
Solid-pseudopapillary neoplasm of pancreas. A. Tumor with prominent blood vessels and small cyst like spaces contrasts with normal pancreatic acini at right. B. Cohesive cell population. C. More dishesive cell population.  D. Vascular pseudopapillae with hyalinized stroma.  E. Aggregates of variably sized hyaline globules. Arrow points to longitudinal nuclear groove. F. Sometimes, as here, the cells show varied nuclear sizes and shapes.  The cytoplasm, lightly eosinophilic to cleared, can have vacuoles (arrows).
 
==IHC==
Features:<ref name=pmid18708424>{{cite journal |author=Serra S, Chetty R |title=Revision 2: an immunohistochemical approach and evaluation of solid pseudopapillary tumour of the pancreas |journal=J. Clin. Pathol. |volume=61 |issue=11 |pages=1153–9 |year=2008 |month=November |pmid=18708424 |doi=10.1136/jcp.2008.057828 |url=http://jcp.bmj.com/content/61/11/1153}}</ref>
*Beta-catenin +ve ~100% (cytoplasmic & nuclear).
*E-cadherin +ve ~100% (cytoplasmic), -ve (membrane); antibody dependent.
*CD10 +ve ~ 80% (cytoplasmic + dot-like) '''key'''.
*Synaptophysin +ve (weak cytoplasmic) ~70%.
*Progesterone receptor +ve (nuclear) '''key'''.
 
Others:
*[[CD56]] +ve.
*Chromogranin -ve.
 
Memory device ''PCB'': '''P'''R (nuclear), '''C'''D10 (cytoplasmic), '''b'''eta-catenin (cytoplasmic & nuclear).
 
==See also==
*[[Pancreas]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Pancreas]]
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