Pancreatic intraepithelial neoplasia (PanIN) is a precursor lesion to pancreatic ductal adenocarcinoma, but the frequency at which this transition occurs is unknown.
Increasing incidence with age 1. Risk factors:
- pancreatic lipomatosis 3
Mostly flat lesions (occasionally papillary), consisting of varying degrees of epithelial atypia and dysplasia. They are histologically classified as low-grade or high-grade.
More commonly located in the pancreatic head 1.
Most are <5 mm, although they may be in the 5-10 mm range.
May produce unifocal or multifocal lobulocentric pancreatic atrophy but a preoperative diagnosis of PanIN is extremely difficult as it is a microscopic lesion 2,4.
- 1. Hruban RH, Maitra A, Goggins M. Update on pancreatic intraepithelial neoplasia. Int J Clin Exp Pathol. 2010;1 (4): 306-16. Free text at pubmed - Pubmed citation
- 2. Ito H, Kawaguchi Y, Kawashima Y et-al. A case of pancreatic intraepithelial neoplasia that was difficult to diagnose preoperatively. Case Rep Oncol. 2015;8 (1): 30-6. doi:10.1159/000371842 - Free text at pubmed - Pubmed citation
- 3. Rebours V, Gaujoux S, d'Assignies G et-al. Obesity and fatty pancreatic infiltration are risk factors for pancreatic precancerous lesions (PanIN). Clin. Cancer Res. . doi:10.1158/1078-0432.CCR-14-2385 - Pubmed citation
- 4. Polvani S, Tarocchi M, Tempesti S et-al. Nuclear receptors and pathogenesis of pancreatic cancer. World J. Gastroenterol. 2014;20 (34): 12062-81. doi:10.3748/wjg.v20.i34.12062 - Free text at pubmed - Pubmed citation
- cystic neoplasm (cystic pancreatic mass differential diagnosis)
- solid neoplasm
- nonepithelial pancreatic neoplasms
- simple pancreatic cyst
pancreatitis (mnemonic for the causes)
- gallstone pancreatitis
- interstitial oedematous pancreatitis
- necrotising pancreatitis
- haemorrhagic pancreatitis
- revised Atlanta classification of acute pancreatitis
- chronic pancreatitis
- Ascaris-induced pancreatitis
- tropical pancreatitis
- autoimmune pancreatitis
- emphysematous pancreatitis
- hereditary pancreatitis
- pancreatitis associated with cystic fibrosis
- segmental pancreatitis
- acute pancreatitis
- pancreatic atrophy
- pancreatic lipomatosis
- pancreatic trauma