Difference between revisions of "Pancreatic intraepithelial neoplasia"

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#redirect [[Pancreas#Pancreatic intraepithelial neoplasia]]
'''Pancreatic intraepithelial neoplasia''', abbreviated '''PanIN''', is generally believed to be the precursor lesion for [[ductal adenocarcinoma of the pancreas]].
 
==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)].
 
==See also==
*[[Pancreas]].
 
==References==
{{Reflist|1}}
 
[[Category:Diagnosis]]
[[Category:Pancreas]]

Latest revision as of 04:26, 21 May 2016

Pancreatic intraepithelial neoplasia, abbreviated PanIN, is generally believed to be the precursor lesion for ductal adenocarcinoma of the pancreas.

General

  • PanIN is thought to be the precursor lesion for pancreatic carcinoma.[1]

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 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.[2]

Microscopic

Features:[1]

  • 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

  • Normal pancreas, pancreatic intraepithelial neoplasia and pancreatic carcinoma. (WC)

www

See also

References

  1. ↑ 1.0 1.1 Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 949. ISBN 0-7216-0187-1.
  2. ↑ Matthaei, H.; Hong, SM.; Mayo, SC.; dal Molin, M.; Olino, K.; Venkat, R.; Goggins, M.; Herman, JM. et al. (Nov 2011). "Presence of pancreatic intraepithelial neoplasia in the pancreatic transection margin does not influence outcome in patients with R0 resected pancreatic cancer.". Ann Surg Oncol 18 (12): 3493-9. doi:10.1245/s10434-011-1745-9. PMID 21537863.
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