| The pancreatic duct and its arteriovenous relationship: an underutilized aid in the diagnosis and distinction of pancreatic adenocarcinoma from pancreatic intraepithelial neoplasia. A study of 126 pancreatectomy specimens. | |
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MedLine Citation:
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PMID: 15105649 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pancreatic intraepithelial neoplasia (PanIN) may be difficult to differentiate from isolated glands of pancreatic adenocarcinoma. We studied the normal relationship between the pancreatic ducts and the pancreatic muscular blood vessels in 126 pancreata, 64 of which were removed for pancreatic adenocarcinoma and 62 for other diagnoses. We also examined the effects that atrophy and PanIN have on this relationship. In normal pancreatic parenchyma and in mild to moderate atrophy, blood vessels are guideposts of the interlobular space. The pancreatic acinar parenchyma ensheathes the pancreatic ductal system and separates it from the muscular pancreatic vasculature. Since these blood vessels do not accompany the pancreatic ducts, the presence of a well-differentiated duct-like structure, which may resemble PanIN, located adjacent to a pancreatic blood vessel should be a clue to the infiltrative and hence malignant nature of that gland. Ducts showing PanIN appear to resist atrophy. Since lobular outlines and vascular landmarks are ultimately lost in severe atrophy, they cannot be relied on to aid in the distinction between PanIN and invasive carcinoma. However, it is unusual to see PanIN1 in such severe atrophy (2%), and although the normal vascular landmarks are no longer there to aid in the interpretation, the presence of well-differentiated duct-like structures resembling PanIN1 in this background should be viewed with suspicion for well-differentiated adenocarcinoma. |
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Authors:
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Shobha Sharma; Kevin B Green |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of surgical pathology Volume: 28 ISSN: 0147-5185 ISO Abbreviation: Am. J. Surg. Pathol. Publication Date: 2004 May |
Date Detail:
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Created Date: 2004-04-23 Completed Date: 2004-06-03 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7707904 Medline TA: Am J Surg Pathol Country: United States |
Other Details:
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Languages: eng Pagination: 613-20 Citation Subset: IM |
Affiliation:
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Department of Pathology, Emory University Hospital, Atlanta, GA 30322-8110, USA. Ssharm2@emory.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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pathology* Arteries / pathology Atrophy / pathology Carcinoma in Situ / pathology* Diagnosis, Differential Humans Pancreatectomy Pancreatic Ducts / blood supply* Pancreatic Neoplasms / pathology* Veins / pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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