Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Ralph Hruban, M.D. and prepared by Jon Davison, M.D.
Case 2: This middle aged woman underwent a distal pancreatectomy and splenectomy.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 188: Case 2
This middle aged woman underwent a distal pancreatectomy and splenectomy for a serous cystadenoma of the pancreas. The lesion shown was in the pancreas, distal to (i.e. on the splenic side of) the serous cystadenoma of the pancreas.images/JMD 6-14-04 SPWC/Case 2/a.jpg
images/JMD 6-14-04 SPWC/Case 2/b.jpg
images/JMD 6-14-04 SPWC/Case 2/c.jpg
images/JMD 6-14-04 SPWC/Case 2/d.jpgCorrect
Answer: Retention cyst
Histology: These dilated pancreatic ducts are mostly lined by a low cuboidal to slightly columnar lining. Focally some of the cells are columnar and contain mucin. The surrounding stroma is relatively acellular.
Discussion: It can be difficult to distinguish between a retention cyst and an early intraductal papillary mucinous neoplasm (IPMN) of the pancreas. By definition, IPMNs involve the larger pancreatic ducts and are composed of tall columnar mucin-producing cells. These cells often form papillae. Retention cysts develop upstream from a site of obstruction of the pancreatic duct. Retention cysts are usually lined by attenuated, but otherwise normal ductal epithelium. In rare cases the epithelium lining a retention cyst is focally lined by a mucin-producing columnar epithelium. In these instances it can be extremely difficult to distinguish between IPMNs and retention cysts. Careful examination of the pancreatic duct is needed. If the duct is probe-patent, the lesion likely represents an early IPMN. In the case presented the duct was obstructed by the adjacent serous cystadenoma; hence, the lesion most likely represents a retention cyst which formed in the pancreas upstream of the obstructing tumor.
Incorrect
Answer: Retention cyst
Histology: These dilated pancreatic ducts are mostly lined by a low cuboidal to slightly columnar lining. Focally some of the cells are columnar and contain mucin. The surrounding stroma is relatively acellular.
Discussion: It can be difficult to distinguish between a retention cyst and an early intraductal papillary mucinous neoplasm (IPMN) of the pancreas. By definition, IPMNs involve the larger pancreatic ducts and are composed of tall columnar mucin-producing cells. These cells often form papillae. Retention cysts develop upstream from a site of obstruction of the pancreatic duct. Retention cysts are usually lined by attenuated, but otherwise normal ductal epithelium. In rare cases the epithelium lining a retention cyst is focally lined by a mucin-producing columnar epithelium. In these instances it can be extremely difficult to distinguish between IPMNs and retention cysts. Careful examination of the pancreatic duct is needed. If the duct is probe-patent, the lesion likely represents an early IPMN. In the case presented the duct was obstructed by the adjacent serous cystadenoma; hence, the lesion most likely represents a retention cyst which formed in the pancreas upstream of the obstructing tumor.
