Document Detail


Focal changes of chronic pancreatitis and duct-arteriovenous relationships: avoiding a diagnostic pitfall.
MedLine Citation:
PMID:  16224220     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prior study of pancreatic duct-arteriovenous relationships suggested that finding ducts near muscularized blood vessels without intervening pancreatic acini indicated adenocarcinoma was present. Because focal changes of chronic pancreatitis are often seen at autopsy, it seemed reasonable to use the autopsy to test the hypothesis that this finding might be nonspecific. An unselected, consecutive series of 81 adult decedent pancreases without known pancreas cancer was evaluated for the presence of ducts near muscularized blood vessels, for fibrosis and/or atrophy, for chronic inflammation, and for duct reduplication and/or proliferation. Autolysis precluded assessment of 26% of the cases. Of evaluable cases, 37% displayed ducts near muscularized blood vessels without intervening pancreatic acini, 23% chronic inflammation, 62% fibrosis and/or atrophy, and 55% duct reduplication and/or proliferation. The finding of ducts near muscularized blood vessels was closely associated with fibrosis and/or atrophy (odds ratio = 28.87, chi = 14.59, P = 0.0001), with duct reduplication and/or proliferation (odds ratio = 19.23, chi = 15.88, P = 0.0001), but not with chronic inflammation (odds ratio = 1.41, chi = 0.05, P > 0.30). Because changes of chronic pancreatitis are associated with ducts near muscularized blood vessels and because chronic pancreatitis can mimic pancreas cancer, care should be exercised when using the finding of ducts near muscularized blood vessels without intervening pancreatic acini as a criterion for the diagnosis of pancreas cancer.
Authors:
Mitchell S Wachtel; Elizabeth J Miller
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  29     ISSN:  0147-5185     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-14     Completed Date:  2006-01-31     Revised Date:  2006-10-13    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1521-3     Citation Subset:  IM    
Affiliation:
Department of Pathology, Texas Tech University School of Medicine, Lubbock, TX, USA. wachtel@ttuhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteries / pathology
Chronic Disease
Humans
Pancreas / pathology*
Pancreatic Ducts / blood supply,  pathology*
Pancreatic Neoplasms / pathology
Pancreatitis / pathology*
Veins / pathology
Comments/Corrections
Comment In:
Am J Surg Pathol. 2006 Sep;30(9):1203-5   [PMID:  16931969 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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