Intraductal papillary squamous neoplasm of the pancreas: Cyto-histologic correlation of a novel entity.
Aged
Carcinoma, Pancreatic Ductal
/ metabolism
Carcinoma, Squamous Cell
/ metabolism
Diagnosis, Differential
Endoscopic Ultrasound-Guided Fine Needle Aspiration
/ methods
Female
Humans
Mutation, Missense
Pain
/ diagnosis
Pancreas
/ diagnostic imaging
Pancreatectomy
/ methods
Pancreatic Neoplasms
/ diagnostic imaging
Proto-Oncogene Proteins p21(ras)
/ genetics
Splenectomy
/ methods
Fine needle biopsy
KRAS
Pancreas cyst
Papillary
Squamous
Journal
Annals of diagnostic pathology
ISSN: 1532-8198
Titre abrégé: Ann Diagn Pathol
Pays: United States
ID NLM: 9800503
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
23
07
2020
revised:
24
07
2020
accepted:
24
07
2020
pubmed:
28
8
2020
medline:
14
7
2021
entrez:
28
8
2020
Statut:
ppublish
Résumé
We correlate the cytologic and histologic features of a squamous-lined pancreatic cystic lesion with a complex papillary architecture and an associated KRAS mutation, which to our knowledge has not been previously described. A 69 year-old woman presented with intermittent left upper quadrant pain. CT imaging revealed a 1 cm solid lesion in the pancreatic tail with peripheral calcification. Endoscopic ultrasound-guided fine needle biopsy showed a proliferation of epithelial cells with fibrovascular cores. An immunohistochemical stain for p40 was positive in the lesional cells. A distal pancreatectomy revealed a unilocular, cystic, well-circumscribed, soft and friable mass measuring 1.0 × 1.0 × 0.8 cm. Histologically, the cyst was lined by nonkeratinizing stratified squamous epithelium with a complex papillary architecture, filling the cyst lumen. Molecular sequencing revealed a KRAS G12V missense mutation. While the lesion shared some histologic features with the previously described "squamoid cyst of the pancreatic ducts", the complex papillary architecture and presence of a KRAS mutation are unique to the entity we describe herein and we propose the name "intraductal papillary squamous neoplasm of the pancreas." Reporting the cytomorphologic features of this novel entity may help in identification of similar lesions and understanding of the clinicopathologic significance.
Identifiants
pubmed: 32847795
pii: S1092-9134(20)30126-X
doi: 10.1016/j.anndiagpath.2020.151583
pmc: PMC8388256
mid: NIHMS1731763
pii:
doi:
Substances chimiques
KRAS protein, human
0
Proto-Oncogene Proteins p21(ras)
EC 3.6.5.2
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
151583Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.
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