Pancreas and Biliary Neoplasia Flashcards
pancreatic ductal adenocarcinoma
most common exocrine pancreatic neoplasm
begins in ductal epithelium w/ pancreatic intraepithelial neoplasia
5 year survival <5%
painless jaundice (60% in head of pancreas)
painless jaundice
tumor involving head of pancreas
serous cystadenoma
- BENIGN, no malignant potential
- multiple small cysts 1-3mm, honeycomb
- lined by layer of cuboidal cells
- only resect if causing sx
IPMN
Intraductal papillary mutinous neoplasm
2 types:
- main duct IPMN
- branch duct IPMN
- cyst communicates w/ pancreatic duct
- mucin producing
- usu involve head of pancreas
- may be multifocal
- epithelial lining to cyst
main duct IPMN
- more aggressive, greater chance of developing malignancy
- more common in men but overall male = female w/ all IPMNs
tx of main duct IPMN
-surgical resection
tx of branch duct IPMN
surveillance monitoring vs surgery based on size, solid or not, location, comorbidities
mutinous cystic neoplasm
95% in body and tail of pancreas
- no ductal system involvement
- may prog to malignancy
tx: surgical resection
mucinous cystic neoplasm histo
large mucin-filled cysts lined by columnar epithelium sim to mucinous cystadenomas in ovary
-stroma of cystic lesion = estrogen receptor +
neuroendocrine tumors of pancreas
single discrete tumor of islet cells
secreting or non-secretions: 1-2% pancreatic tumors
G-cell tumors
gastrinoma
Zollinger-Ellison Syndrome
enterochromaffin tumor
carcinoid syndrome
B-cell pancreas tumor
insulinoma
most common
endocrine neoplasia
criteria of malignancy
demonstration of mets and invasion of surrounding organs/tissues
gallbladder adenoma
detected incidentally
-pre-malignant lesion
gallbladder adenomyoma (adenomyomatosis)
-benign, small, solitary mass in FUNDUS of gallbladder
gallbladder cancer
95% adenocarcinoma
poor prognosis
gallstones/cholecystitis is present in __% of gallbladders w/ cancer
90%
cholangiocarcinoma
rare cancer of bile duct epithelial cells
no relationship to presence of gallstones
almost all are adenocarcinomas
perihilar location
major risk fx: primary sclerosing cholangitis
major risk factor for cholangiocarcinoma
primary sclerosing cholangitis
klatskin tumors
cholangiocarcinoma located at junction of L and R hepatic ducts (perihilar)
