[Clinicopathological studies on pancreatic carcinoma in totally pancreatectomized cases--with special reference to its intrapancreatic development and the pancreatogram].

Histological examination and pancreatography were performed on 31 totally pancreatectomized cases of pancreatic ductal carcinoma, which was divided into four types according to its growth pattern in the pancreas. Pancreatograms of the resected specimens were also classified according to histological findings. Pancreatic carcinoma of Type I (20 cases) was diffusely infiltrating carcinoma with scirrhous stroma which was particularly present between the lobules. The pancreatogram of this type showed constriction of the main pancreatic duct accompanied by dilatation of the distal pancreatic duct. Carcinoma of Type II (6 cases) was diffusely developing in or around the dilated main pancreatic duct or its branches. The pancreatogram of Type II demonstrated the irregularly dilated main pancreatic duct with absence of its branches. Type III (4 cases) was the localized carcinoma with medullary structure. The pancreatogram showed replacement and dilatation of pancreatic ducts without marked stenosis of the main pancreatic duct. Type IV (1 case) was intraductal protruding carcinoma which showed polypoid shadow defects in remarkably dilated pancreatic ducts. The results suggested that a total pancreatectomy should be applied mainly for pancreatic carcinomas of Type II.