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Presented by Ralph Hruban, M.D. and prepared by Maryam Farinola M.D.
Case 6: ERCP revealed a stricture of the pancreatic ducts.
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Question 1 of 1
1. Question
Week 178: Case 6
ERCP revealed a stricture of the pancreatic ducts.images/retention cyst 1.jpg
images/retention cyst 2.jpg
images/retention cyst 3.jpg
images/retention cyst 4.jpgCorrect
Answer: Retention cyst
Histology: The stricture of the pancreatic duct was caused by an islet cell tumor (well-differentiated pancreatic endocrine neoplasm). The lesion illustrated represents a dilated pancreatic duct. The duct is lined by uniform cubiodal to columnar epithelium. Intracellular and extracellular mucin production is not prominent.
Discussion: Retention cysts are non-neoplastic dilations of the pancreatic duct. Retention cysts need to be distinguished from intraductal papillary mucinous neoplasms (IPMNs). IPMNs and retention cysts both involve the ducts. IPMNs produce abundant quantities of extracellular mucin and are lined by neoplastic mucin-producing columnar cells. These cells often, although not always, form papillae. Retention cysts do not produce copious amounts of mucin. They are lined by flat reactive epithelial cells. Retention cysts are caused by duct obstruction and a careful search of the pancreatic ducts will often disclose the etiology of the duct obstruction, helping to establish the diagnosis.
Incorrect
Answer: Retention cyst
Histology: The stricture of the pancreatic duct was caused by an islet cell tumor (well-differentiated pancreatic endocrine neoplasm). The lesion illustrated represents a dilated pancreatic duct. The duct is lined by uniform cubiodal to columnar epithelium. Intracellular and extracellular mucin production is not prominent.
Discussion: Retention cysts are non-neoplastic dilations of the pancreatic duct. Retention cysts need to be distinguished from intraductal papillary mucinous neoplasms (IPMNs). IPMNs and retention cysts both involve the ducts. IPMNs produce abundant quantities of extracellular mucin and are lined by neoplastic mucin-producing columnar cells. These cells often, although not always, form papillae. Retention cysts do not produce copious amounts of mucin. They are lined by flat reactive epithelial cells. Retention cysts are caused by duct obstruction and a careful search of the pancreatic ducts will often disclose the etiology of the duct obstruction, helping to establish the diagnosis.
