From the Department of Gastroenterology, Onomichi General Hospital, Onomichi.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima.
Pancreas. 2021 Mar 1;50(3):399-404. doi: 10.1097/MPA.0000000000001771.
This study aimed to evaluate the pathological features and imaging findings of pancreatic carcinoma in situ (PCIS).
Twenty patients with PCIS were categorized as flat (F) (n = 6) and low papillary (LP) (n = 14) types.
None of F type and 8 (57%) of 14 with LP type lesions showed intraductal infiltrations of the main pancreatic duct (MPD) greater than 10 mm. None of F type and 3 (21%) of 14 with LP type lesions showed skip lesions in the MPD. Magnetic resonance cholangiopancreatography showed irregular MPD stenoses in 5 (83%) of 6 with F and 13 (100%) of 13 with LP type lesions. Magnetic resonance cholangiopancreatography determined that the median lengths of the irregular MPD stenoses were 3.6 mm for F, and 11.6 mm for LP type lesions. Endoscopic retrograde cholangiopancreatography determined that the median lengths of the irregular MPD stenoses were 2.8 mm for F, and 14.3 mm for LP type lesions. Pancreatic cancer recurrences limited to the remnant pancreas occurred in 2 patients with LP type lesions.
In LP type PCIS, intraductal infiltration of the MPD occurs frequently. There may be multiple lesions, and lesions may recur in the remnant pancreas. Long-term strict follow-up assessments should be implemented for LP type PCIS.
本研究旨在评估胰腺原位癌（PCIS）的病理特征和影像学表现。
将 20 例 PCIS 患者分为平坦型（F 型）（n = 6）和低乳头状（LP 型）（n = 14）。
F 型中无 1 例，LP 型中 14 例中有 8 例（57%）主胰管（MPD）内浸润大于 10mm。F 型中无 1 例，LP 型中 14 例中有 3 例（21%）有 MPD 跳跃性病变。磁共振胰胆管成像（MRCP）显示 6 例 F 型中有 5 例（83%）和 13 例 LP 型中有 13 例（100%）MPD 不规则狭窄。MRCP 显示 F 型不规则 MPD 狭窄的中位数长度为 3.6mm，LP 型为 11.6mm。内镜逆行胰胆管造影（ERCP）显示 F 型不规则 MPD 狭窄的中位数长度为 2.8mm，LP 型为 14.3mm。2 例 LP 型病变患者局限于残胰腺的胰腺癌复发。
在 LP 型 PCIS 中，MPD 内浸润较常见。可能有多发性病变，病变可能在残胰腺中复发。对 LP 型 PCIS 应进行长期严格的随访评估。
