Pancreas and Biliary Neoplasia Flashcards

1
Q

pancreatic ductal adenocarcinoma

A

most common exocrine pancreatic neoplasm

begins in ductal epithelium w/ pancreatic intraepithelial neoplasia

5 year survival <5%

painless jaundice (60% in head of pancreas)

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2
Q

painless jaundice

A

tumor involving head of pancreas

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3
Q

serous cystadenoma

A
  • BENIGN, no malignant potential
  • multiple small cysts 1-3mm, honeycomb
  • lined by layer of cuboidal cells
  • only resect if causing sx
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4
Q

IPMN

Intraductal papillary mutinous neoplasm

A

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
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5
Q

main duct IPMN

A
  • more aggressive, greater chance of developing malignancy

- more common in men but overall male = female w/ all IPMNs

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6
Q

tx of main duct IPMN

A

-surgical resection

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7
Q

tx of branch duct IPMN

A

surveillance monitoring vs surgery based on size, solid or not, location, comorbidities

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8
Q

mutinous cystic neoplasm

A

95% in body and tail of pancreas

  • no ductal system involvement
  • may prog to malignancy

tx: surgical resection

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9
Q

mucinous cystic neoplasm histo

A

large mucin-filled cysts lined by columnar epithelium sim to mucinous cystadenomas in ovary
-stroma of cystic lesion = estrogen receptor +

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10
Q

neuroendocrine tumors of pancreas

A

single discrete tumor of islet cells

secreting or non-secretions: 1-2% pancreatic tumors

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11
Q

G-cell tumors

A

gastrinoma

Zollinger-Ellison Syndrome

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12
Q

enterochromaffin tumor

A

carcinoid syndrome

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13
Q

B-cell pancreas tumor

A

insulinoma

most common

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14
Q

endocrine neoplasia

criteria of malignancy

A

demonstration of mets and invasion of surrounding organs/tissues

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15
Q

gallbladder adenoma

A

detected incidentally

-pre-malignant lesion

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16
Q

gallbladder adenomyoma (adenomyomatosis)

A

-benign, small, solitary mass in FUNDUS of gallbladder

17
Q

gallbladder cancer

A

95% adenocarcinoma

poor prognosis

18
Q

gallstones/cholecystitis is present in __% of gallbladders w/ cancer

A

90%

19
Q

cholangiocarcinoma

A

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

20
Q

major risk factor for cholangiocarcinoma

A

primary sclerosing cholangitis

21
Q

klatskin tumors

A

cholangiocarcinoma located at junction of L and R hepatic ducts (perihilar)