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Intraductal Papillary Mucinous Neoplasms

  • Lorene Yoxtheimer
  • Abha GoyalEmail author
Chapter
Part of the Essentials in Cytopathology book series (EICP, volume 28)

Abstract

With ever-increasing use of cross-sectional abdominal imaging, there has been a rise in the number of asymptomatic pancreatic cysts that are detected incidentally, the management of which poses a major issue. A large proportion of these asymptomatic pancreatic cysts are believed to comprise of branch duct intraductal papillary mucinous neoplasms (IPMNs). Depending upon the involvement of the branch ducts and/or main pancreatic duct, IPMNs can be subdivided into branch duct IPMN, main duct IPMN, and mixed- or combined-type IPMN. Main duct IPMNs are associated with the highest rate of malignancy (mean frequency, 61.6%). Four distinct histologic subtypes of IPMNs are recognized based on the type of epithelial lining: gastric, intestinal, pancreatobiliary, and oncocytic. Based on the highest degree of architectural and cytologic atypia, the epithelial dysplasia is graded as low, intermediate, and high. The preoperative diagnosis of IPMNs is based on a multimodal approach comprising of clinical and imaging findings and cyst fluid analysis with cytologic examination. This chapter will discuss various aspects of IPMNs including the clinical features, imaging findings, pathologic features, molecular genetics, and management recommendations.

Keywords

Intraductal papillary mucinous neoplasm IPMN Neoplastic mucinous cyst Endoscopic ultrasound Fine needle aspiration 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineWeill-Cornell Medicine, New York Presbyterian HosptialNew YorkUSA

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