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Pancreatic intraepithelial neoplasia (view source)
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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.<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:Diagnosis]] | ||
[[Category:Pancreas]] | |||