An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms Journal Article


Authors: Hruban, R. H.; Takaori, K.; Klimstra, D. S.; Adsay, N. V.; Albores-Saavedra, J.; Biankin, A. V.; Biankin, S. A.; Compton, C.; Fukushima, N.; Furukawa, T.; Goggins, M.; Kato, Y.; Klöppel, G.; Longnecker, D. S.; Luttges, J.; Maitra, A.; Offerhaus, G. J. A.; Shimizu, M.; Yonezawa, S.
Article Title: An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms
Abstract: Invasive pancreatic ductal adenocarcinoma is an almost uniformly fatal disease. Several distinct noninvasive precursor lesions can give rise to invasive adenocarcinoma of the pancreas, and the prevention, detection, and treatment of these noninvasive lesions offers the potential to cure early pancreatic cancers. Noninvasive precursors of invasive ductal adenocarcinoma of the pancreas include pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms. Diagnostic criteria, including a distinct ovarian-type stroma, and a consistent nomenclature are well established for mucinous cystic neoplasms. By contrast, consistent nomenclatures and diagnostic criteria have been more difficult to establish for PanINs and IPMNs. Because both PanINs and IPMNs consist of intraductal neoplastic proliferations of columnar, mucin-containing cells with a variable degree of papilla formation, the distinction between these two classes of precursor lesions remains problematic. Thus, considerable ambiguities still exist in the classification of noninvasive neoplasms in the pancreatic ducts. A meeting of international experts on precursor lesions of pancreatic cancer was held at The Johns Hopkins Hospital from August 18 to 19, 2003. The purpose of this meeting was to define an international acceptable set of diagnostic criteria for PanINs and IPMNs and to address a number of ambiguities that exist in the previously reported classification systems for these neoplasms. We present a consensus classification of the precursor lesions in the pancreatic ducts, PanINs and IPMNs.
Keywords: cancer survival; survival rate; conference paper; pancreas cancer; pancreatic neoplasms; adenocarcinoma; consensus; carcinoma, pancreatic ductal; practice guideline; carcinoma in situ; diagnosis; pancreas duct; pancreas tumor; pancreas adenocarcinoma; world health organization; nomenclature; cancer classification; mucinous carcinoma; mucinous cystic neoplasm; practice guidelines; pancreatic intraepithelial neoplasia; pancreas ductal adenocarcinoma; cystadenocarcinoma, mucinous; cystadenocarcinoma, papillary; humans; human; intraductal papillary mucinous neoplasm (ipmn); pancreatic intraepithelial neoplasia (panin); pancreatic intraductal papillary mucinous neoplasm
Journal Title: American Journal of Surgical Pathology
Volume: 28
Issue: 8
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2004-08-01
Start Page: 977
End Page: 987
Language: English
DOI: 10.1097/01.pas.0000126675.59108.80
PROVIDER: scopus
PUBMED: 15252303
DOI/URL:
Notes: Am. J. Surg. Pathol. -- Cited By (since 1996):495 -- Export Date: 16 June 2014 -- CODEN: AJSPD -- Source: Scopus
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  1. David S Klimstra
    978 Klimstra