Pancreatic neoplasms
Updates to Article Attributes
Body
was changed:
There are numerous primary pancreatic neoplasms, in part due to the mixed endocrine and exocrine components.
Classification
Classification based on function
-
exocrine - ~ 99% of all primary pancreatic neoplasms
- pancreatic ductal adenocarcinoma ~ 90-95%
- cystic neoplasm
- intraductal papillary mucinous neoplasm (IPMN)
-
endocrine -
werewere previously referred as islet cell tumors because they were thought to have originated from the islets of Langerhans. However, new evidence suggests that these tumors originate from pluripotential stem cells in ductal epithelium 6.- non-functional
- functional
-
mesenchymal tumours
- although the great majority of both benign and malignant pancreatic neoplasms arise from pancreatic epithelial cells, mesenchymal tumors, while rare, can derive from the connective, lymphatic, vascular, and neuronal tissues of the pancreas7.
- they account for 1-2% of all pancreatic tumors and are classified according to their histologic origin7.
- other
Exocrine tumours
- ductal adenocarcinoma is by far the most common primary tumour, usually of the head (65%) and has a very poor prognosis.
-
cystic neoplasms are further divided into: (with some overlap)
- unilocular
- intraductal papillary mucinous neoplasms(IPMN)
- serous cystadenoma uncommonly uni/macro locular
- macrocystic - multilocular
- mucinous cystic neoplasm : usually body and tail
- intraductal papillary mucinous neoplasms (IPMN)
- serous cystadenoma uncommonly uni / macro locular
- microcystic
- serous cystadenoma - usually head. 30% have a central scar
- cystic with a solid component
- macrocystic tumours can have solid component also
- unilocular
- generally solid
See also - cystic pancreatic mass : differential diagnosis
Endocrine tumours
Endocrine tumours of the pancreas are divided into :
-
functional - ~ 85 %
- insulinoma - most common. 10% are malignant
- gastrinoma - second most common. 60% malignant
- glucagonoma - 80% malignant
- VIPoma - 75% malignant
- somatostatinoma - 75% malignant
-
non-functional - ~ 15% :
- third most common
- 85-100% malignant
- usually larger
Mesenchymaltumours tumours
Account for 1-2% of all pancreatic tumors and are classified according to their histologic origin7:
- lymphangioma
- lipoma
- pancreatoblastoma
- teratoma
- lymphoma
- schwannoma
- neurofibroma
- sarcoma
Classification based on location
Head
- serous cystadenoma
- intraductal papillary mucinous neoplasms (IPMN)
- ductal adenocarcinoma
- pancreatoblastoma (rare and in children)
Body and tail
-<p>There are numerous primary <strong>pancreatic neoplasms</strong>, in part due to the mixed endocrine and exocrine components.</p><p> </p><h4>Classification</h4><h5>Classification based on function</h5><ul>- +<p>There are numerous primary <strong>pancreatic neoplasms</strong>, in part due to the mixed endocrine and exocrine components.</p><h4>Classification</h4><h5>Classification based on function</h5><ul>
-<strong>exocrine </strong>- ~ 99% of all primary pancreatic neoplasms<ul>- +<strong>exocrine </strong>- ~ 99% of all primary pancreatic neoplasms<ul>
-<strong>endocrine </strong>- were previously referred as islet cell tumors because they were thought to have originated from the islets of Langerhans. However, new evidence suggests that these tumors originate from pluripotential stem cells in ductal epithelium <sup>6</sup>.<ul>- +<strong>endocrine </strong>- were previously referred as islet cell tumors because they were thought to have originated from the islets of Langerhans. However, new evidence suggests that these tumors originate from pluripotential stem cells in ductal epithelium <sup>6</sup>.<ul>
-</ul><h5>Exocrine tumours</h5><p> </p><ul>- +</ul><h5>Exocrine tumours</h5><ul>
-</ul><h5>-<strong>Mesenchymal </strong>tumours</h5><p>Account for 1-2% of all pancreatic tumors and are classified according to their histologic origin<sup>7</sup>:</p><ul>- +</ul><h5>Mesenchymal tumours</h5><p>Account for 1-2% of all pancreatic tumors and are classified according to their histologic origin<sup>7</sup>:</p><ul>
-</ul><h5>Classification based on location </h5><h6><strong>Head</strong></h6><ul>- +</ul><h5>Classification based on location </h5><h6>Head</h6><ul>
-</ul><h6><strong>Body and tail</strong></h6><ul>- +</ul><h6>Body and tail</h6><ul>
References changed:
- 4. Cho H, Choi J, Kim M et al. Pancreatic Tumors: Emphasis on CT Findings and Pathologic Classification. Korean J Radiol. 2011;12(6):731. <a href="https://doi.org/10.3348/kjr.2011.12.6.731">doi:10.3348/kjr.2011.12.6.731</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22043156">Pubmed</a>
- 4. <a href="http://www.medcyclopaedia.com/" title="http://www.medcyclopaedia.com/" class="external text" rel="nofollow">AmershamHeath Medcyclopaedia</a>
Images Changes:
Image ( update )
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Case 1 -: ductal adenocarcinoma
Image ( update )
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Case 2 -: solid-pseudopapillary tumour
Image 1 Pathology (Gross pathology) ( update )
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Image 3 MRI (T2 fat sat) ( update )
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Case 6 -: insulinoma
Image 4 MRI (T1 fat sat) ( update )
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Case 3 -: insulinoma
Image 5 CT (C+ portal venous phase) ( update )
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Case 4 -: islet-cell tumour
Image 6 CT (C+ portal venous phase) ( update )
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Case 5 -: pancreatic duct adenocarcinoma
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