Intraductal Tubular Carcinoma of the Pancreas
Definition
- Cytologically atypical nodular pancreatic intraductal epithelial proliferation with a predominantly tubular architecture
Alternate/Historical Names
- Intraductal and cystic tubulopapillary adenocarcinoma
- Intraductal tubular carcinoma
- Intraductal tubular neoplasm with high grade dysplasia
- Intraductal tubular tumor
- Microcystic tubulopapillary carcinoma
- Intraductal tubulopapillary neoplasm (WHO 2010 preferred term)
Diagnostic Criteria
- Nodular intraductal growth
- Duct dilated locally
- May fill and obliterate duct lining
- Upstream pancreas may be atrophic
- Duct dilated locally
- Tubular growth pattern
predominates
- Tightly packed tubules
- Variable sized tubules
- May be cribriform
- May be focally to predominantly papillary
- Cuboidal to columnar cells resembling normal pancreatic duct cells
- Scant to moderate amount of cytoplasm
- Eosinophilic to amphophilic cytoplasm
- Scant to absent cytoplasmic mucin
- No evidence of mucin secretion
- No distension of ducts by mucin
- No goblet cells
- Scant to moderate amount of cytoplasm
- No acinar differentiation
- Moderate to marked cytologic atypia
- Frequent mitotic figures
- Frequent necrosis
- May be associated with invasive carcinoma
- Metastases reported to local nodes, liver and peritoneum
- Even in the presence of metastases, behavior of carcinoma appears better than for conventional pancreatic carcinoma, with few deaths
- Intraductal tubular adenoma does not appear to be related to intraductal tubular carcinoma
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : August 25, 2009