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dc.contributor.authorKelly, Paul J.
dc.contributor.authorShinagare, Shweta
dc.contributor.authorSainani, Nisha I.
dc.contributor.authorHong, Xiao
dc.contributor.authorFerrone, Cristina Rosa
dc.contributor.authorYilmaz, Omer Hidir
dc.contributor.authorFernandez-Del Castillo, Carlos F.
dc.contributor.authorLauwers, Gregory Y.
dc.contributor.authorDeshpande, Vikram
dc.date.accessioned2018-03-26T17:40:50Z
dc.date.issued2012
dc.identifier.citationKelly, Paul J., Shweta Shinagare, Nisha Sainani, Xiao Hong, Cristina Ferrone, Omer Yilmaz, Carlos Fernández-del Castillo, Gregory Y. Lauwers, and Vikram Deshpande. 2012. “Cystic Papillary Pattern in Pancreatic Ductal Adenocarcinoma.” The American Journal of Surgical Pathology 36 (5) (May): 696–701. doi:10.1097/pas.0b013e318249ce1c.en_US
dc.identifier.issn0147-5185en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:35136028
dc.description.abstractINTRODUCTION: The prototypic pancreatic ductal adenocarcinoma shows small-caliber glands that are placed within an exuberant desmoplastic stromal reaction. A number of histologic patterns have been described, and the majority of these patterns are genetically and biologically related to conventional ductal adenocarcinomas. In this report we describe our experience with a heretofore undescribed histologic pattern of pancreatic adenocarcinoma that mimics intraductal papillary mucinous carcinoma, both morphologically and radiologically. METHODS: We identified 10 cases of pancreatic adenocarcinoma with large-caliber malignant glands and an intraluminal papillary pattern. The demographic, clinical, radiologic, and outcome data were recorded. In addition to a review of the histologic features we also performed elastin stains, immunohistochemistry for selected oncogenes and tumor suppressor genes including SMAD4. Immunohistochemical staining for MUC proteins was also performed. RESULTS: The median age of the patients was 67 years, and there were 6 women and 4 men. Grossly, the cut surface in 6 of these cases showed an admixture of solid and cystic areas. The papillary cystic architecture was intimately mixed with areas of conventional adenocarcinoma, the latter characterized by invasive small-caliber tubular structures. None of the tumors showed a pure papillary cystic pattern; however, in 8 cases, this was the predominant pattern (>50% of the tumor). The cysts and papillae were lined predominantly by tall columnar hypermucinous epithelium. Elastin fibers were not identified around these dilated malignant cysts and glands. The intratumoral stroma was paucicellular and hyalinized. Seven of the 10 tumors were negative for SMAD4. The lack of pericystic elastin fibers and loss of SMAD4 in the majority of cases argue against these lesions representing an intraductal papillary mucinous neoplasm. All 10 tumors stained for MUC1; focal MUC2 reactivity was noted in 1 case. The majority of cases were positive for MUC5AC (9/10) and MUC6 (8/10). Seven patients died of their disease, whereas 1 patient is alive with widely metastatic disease. Two patients were lost to follow up. CONCLUSIONS: The adenocarcinoma described herein is a unique morphologic pattern of pancreatic ductal adenocarcinoma. The biology and genetics (as estimated by immunohistochemistry) are no different from that of conventional ductal adenocarcinoma but are distinctly different from thaten_US
dc.language.isoen_USen_US
dc.publisherOvid Technologies (Wolters Kluwer Health)en_US
dc.relation.isversionofdoi:10.1097/PAS.0b013e318249ce1cen_US
dash.licenseMETA_ONLY
dc.subjectpancreatic ductal adenocarcinomaen_US
dc.subjectintraductal papillary mucinous neoplasmen_US
dc.subjectcystic papillary patternen_US
dc.titleCystic Papillary Pattern in Pancreatic Ductal Adenocarcinomaen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalThe American Journal of Surgical Pathologyen_US
dash.depositing.authorLauwers, Gregory Y.
dash.embargo.until10000-01-01
dc.identifier.doi10.1097/PAS.0b013e318249ce1c*
workflow.legacycommentsnoap.needmanen_US
dash.authorsorderedfalse
dash.contributor.affiliatedSainani, Nisha
dash.contributor.affiliatedLauwers, Gregory Y.
dash.contributor.affiliatedFernandez-Del Castillo, Carlos
dash.contributor.affiliatedFerrone, Cristina
dash.contributor.affiliatedYilmaz, Omer
dash.contributor.affiliatedDeshpande, Vikram
dc.identifier.orcid0000-0003-4230-9308


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