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Presented by Ralph Hruban, M.D. and prepared by Maryam Farinola M.D.
Case 1: This patient had a mass in the head of the pancreas.
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Question 1 of 1
1. Question
Week 143: Case 1
This patient had a mass in the head of the pancreas. The slide shown is from the pancreatic neck margin. The lesion was not visible grossly./images/070703case1fig1.jpg
/images/070703case1fig2.jpg
/images/070703case1fig3.jpgCorrect
Answer: Pancreatic intraepithelial neoplasia
Histology: The lesion shown is a papillary proliferation in a small duct. It was too small to be seen grossly. Columnar cells with atypia line the papillae.
Discussion: The lesion is Pancreatic Intraepithelial Neoplasia (PanIN). IPMNs are, by definition, visible grossly and > 1 cm. It is too small to be an IPMN. PanINs can be categorized into PanIN-1A, PanIN-1B, PanIN-2 and PanIN-3 based on the degree of architectural and nuclear atypia. PanINs are important to recognize for two reasons. First, PanINs are believed to be the precursor lesions to infiltrating ductal adenocarcinoma. Second, PanINs can mimic an infiltrating carcinoma.
Incorrect
Answer: Pancreatic intraepithelial neoplasia
Histology: The lesion shown is a papillary proliferation in a small duct. It was too small to be seen grossly. Columnar cells with atypia line the papillae.
Discussion: The lesion is Pancreatic Intraepithelial Neoplasia (PanIN). IPMNs are, by definition, visible grossly and > 1 cm. It is too small to be an IPMN. PanINs can be categorized into PanIN-1A, PanIN-1B, PanIN-2 and PanIN-3 based on the degree of architectural and nuclear atypia. PanINs are important to recognize for two reasons. First, PanINs are believed to be the precursor lesions to infiltrating ductal adenocarcinoma. Second, PanINs can mimic an infiltrating carcinoma.
