High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report  

作　　者：Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka Yoshiyuki Shibata Sho Tazuma Takeshi Sudo Hiroshi Kohno Shiro Oka 

机构地区：[1]Department of Gastroenterology,National Hospital Organization Kure Medical Center and Chugoku Cancer Center,Kure 737-0023,Hiroshima,Japan [2]Department of Gastroenterology,Hiroshima University Hospital,Hiroshima 734-8551,Hiroshima,Japan [3]Department of Pathology,National Hospital Organization Kure Medical Center and Chugoku Cancer Center,Kure 737-0023,Hiroshima,Japan [4]Department of Surgery,National Hospital Organization Kure Medical Center and Chugoku Cancer Center,Kure 737-0023,Hiroshima,Japan

出　　处：《World Journal of Clinical Cases》2024年第8期1487-1496,共10页世界临床病例杂志

摘　　要：BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关 键 词：Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]