Intraductal papillary squamous neoplasm of the pancreas: Cyto-histologic correlation of a novel entity Journal Article
| Authors: | Hagen, C. E.; Christians, K.; Hopp, A.; Giorgadze, T.; Hartley, C. P.; Hunt, B.; Basturk, O.; Klimstra, D. |
| Article Title: | Intraductal papillary squamous neoplasm of the pancreas: Cyto-histologic correlation of a novel entity |
| Abstract: | 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. © 2020 Elsevier Inc. |
| Keywords: | immunohistochemistry; clinical article; human tissue; aged; cancer surgery; human cell; missense mutation; splenectomy; case report; diarrhea; hypertension; cell proliferation; protein blood level; breast cancer; nausea; ca 19-9 antigen; intraductal papillary mucinous tumor; pancreas cyst; gene frequency; histology; cancer cytodiagnosis; family history; mesothelioma; epithelium cell; probiotic agent; cytokeratin 7; kras; hypothyroidism; gastroesophageal reflux; k ras protein; general practitioner; patent foramen ovale; chromogranin; burning sensation; distal pancreatectomy; spleen artery; microdissection; common acute lymphoblastic leukemia antigen; protein p40; papillary; squamous; medical history; irritable colon; cd56 antigen; peroperative echography; lymph follicle; upper abdominal pain; splenic vein; high throughput sequencing; endoscopic ultrasound guided fine needle biopsy; granular cell; human; female; priority journal; article; robot assisted surgery; x-ray computed tomography; fine needle biopsy; mitral valve prolapse; pancreas calcification |
| Journal Title: | Annals of Diagnostic Pathology |
| Volume: | 48 |
| ISSN: | 1092-9134 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2020-10-01 |
| Start Page: | 151583 |
| Language: | English |
| DOI: | 10.1016/j.anndiagpath.2020.151583 |
| PROVIDER: | scopus |
| PUBMED: | 32847795 |
| PMCID: | PMC8388256 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2020 -- Source: Scopus |
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