Difference between revisions of "Pancreas"

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Pancreas (view source)

Revision as of 10:20, 5 March 2014

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→‎Solid pseudopapillary tumour: split out
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*[[AKA]] ''solid pseudopapillary neoplasm'', abbreviation ''SPN''.
*[[AKA]] ''solid pseudopapillary neoplasm'', abbreviation ''SPN''.
*[[AKA]] ''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>
*[[AKA]] ''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>
 
{{Main|Solid pseudopapillary tumour}}
===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>
 
====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)].
 
====DDx====
*[[Pancreatic pseudocyst]].
*Cystadenoma.
*Cystadenocarcinoma.
*[[Pancreatic neuroendocrine tumour]] - may have cytoplasmic vacuolation, [[hyaline globules]].<ref name=pmid18708424/>
 
===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).


=Pre-malignant lesions=
=Pre-malignant lesions=
Michael
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