Pancreatic intraepithelial neoplasia
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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)
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See also
References
- ↑ 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.
- ↑ 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.