[Papillary and cystic tumors of the pancreas. Clinico-pathological, cytopathological, immunohistochemical, and nuclear ploidy study].

Seven cases of PCNP were studied; 5 females and 2 males, ages ranging from 21 to 68 years (mean 39). All had asymptomatic masses located in the head (3), body (2), isthmus (1) and tail (1). In 4 of them fine-needle aspiration (FNA) was done and showed a diagnostic pattern with papillary clusters as well as isolated epithelial cells with monomorphic appearance, round nuclei and inconspicuous nucleoli; 5 cases had a surgical resection and only 2 a biopsy due to unresectable tumors. Histologically, they showed the typical features of PCNP with solid, papillary, trabecular and cystic patterns. IHQ studies showed positivity for cytokeratin (n = 5), alpha-1-antitrypsin (n = 4), monoclonal NSE (n = 3), chromogranin (n = 3) and estrogen receptors (n = 1). All cases were negative for insulin, glucagon, somatostatin, EMA and CEA. DNA analysis done with an image analyzer showed 4 diploid tumors, 2 diploid-tetraploid an 1 aneuploid tumor. One patient died because of postoperative complications and the remaining 6 are alive with a mean follow-up of 17 months (2-36). We emphasize the diagnostic appearance of the tumor on FNA, and the low grade malignant potential of this neoplasm supported by the predominance of diploid tumors. Our IHQ findings suggest both an exocrine and endocrine differentiation.