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Mucin Producing Cystic Tumor of the Pancreas Detected by Operative Pancreatoscopy, Report of a Case Yasuyuki Asada 1 , Syoji Miura 1 , Fumio Konishi 4 1Department of Surgery, Fukuiken-Saiseikai Hospital 4Department of Pathology, Kanazawa Medical School Keyword: 膵管内乳頭状腺癌 , 粘液産生膵腫瘍 pp.675-680
Published Date 1991/6/25
DOI https://doi.org/10.11477/mf.1403102564
  • Abstract
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 A 69-year-old man was admitted to our hospital, because of abdominal pain. Laboratory data on admission was normal except for the elevation of ESR (Table 1). Abdominal ultrasonography (US) demonstrated marked dilatation of the main pancreatic duct (MPD) and atrophy of the pancreas (Fig. 1a). Enhanced CT scan (Fig. 2) and endoscopic ultrasonography (EUS) (Fig. 1b) showed a cystic lesion in the pancreatic tail. Endoscopic retrograde pancreatography (ERP) showed dilatation of the MPD (Fig. 3) in which a lot of mucus was contained. However, examination before the operation demonstrated no neoplastic lesion in the cystic dilatation of the pancreatic duct. By using pancreatoscope during the operation, granular and villous mucosa was revealed in the MPD of the pancreatic tail (Fig. 4). This was diagnosed as mucin producing tumor of the pancreas. Distal pancreatectomy was performed.

 Examination of the resected materials revealed granular and low-elevated tumors spreading superficially in the dilated MPD of the pancreatic body and tail (Fig. 6). These tumors were histologically papillary, nonpapillary, vinous, and flat tumors consisting of mucin producing columnar epithelia with nuclear pseudostratification and structural atypia showing severe dysplasia in some parts (Figs. 7, 8). This type of tumor was considered to be intraductal papillary adenocarcinoma (low grade malignancy).


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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