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Intraductal mucinous papillary neoplasms of the pancreas: a clinicopathological study of 17 cases.
Intraductal mucinous neoplasms (IMNs) of the pancreas are relatively uncommon and have recently been recognised as a subgroup of IPMNs. The aim of this study was to elucidate the clinicopathological features and natural course of IMNs. A retrospective analysis was conducted of 17 patients with IMNs. Data were collected from the patients’ medical charts and the pathology database. The mean age of the patients was 60.5 years. The most common presenting symptom was abdominal pain and the most common sign was jaundice. All patients were free of disease at follow-up. Intraductal papillary mucinous tumours, IMNs and IPMNs were pathologically distinguished from one another. The mean size of the tumours was 2.85 cm. The median diameter of IMNs was 3.1 cm. The IMNs exhibited a remarkable histological resemblance to that of IPMNs. IMNs were characterised by cystic, pseudo-papillary proliferations lined by two- to four-layered columnar epithelium, which is devoid of nuclear atypia. The IMNs were associated with surrounding pancreatic ductal adenocarcinoma in one patient (6.1%) and caused the death of the other patient due to invasion of the duodenum. All patients were free of disease at follow-up. IMNs are rare neoplasms that should be distinguished from IPMNs because these two diseases have different clinical and pathological features. IMNs may have a malignant potential and may have a similar histological finding to that of IPMNs.
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