Pancreatic Cancer

Question 1

What are the precursor lesions of pancreatic carcinoma

Answer 1

Pancreatic intra-epithelial neoplasms(PanIN)

Question 2

Pan IN 1 due to

Answer 2

Telomere shortening → chromosomal abnormalities
KRAS

Question 3

Pan IN 2 due to

Answer 3

Inactivation of p16 which control cell cycle

Question 4

Pan IN 3 due to

Answer 4

Inactivation of T53

Question 5

Location

Answer 5

60% head
15% body
20% diffuse

Question 6

Gross

Answer 6

Greyish white hard firm mass

Question 7

Microscopy

Answer 7

Aden carcinoma
Abortive tubular structures

Question 8

Risk factors

Answer 8

Consumption of diet rich in fats
Alcohol
Cigarette
Diabetes mellitus
BRCA 2 mutations.
P 16 mutation

Question 9

Clinical feature-

Answer 9

Pain
Obstructive jourdice when head of pancreas is involved
Carcinoma of body, tail are silent
Migratory thrombophlebitis ( trousseau syndrome)

Question 10

Raised serum levels of:-

Answer 10

Carcino embryonic antigen
CA 19 - 9 antigen

Question 11

Trousseau syndrome

Answer 11

Spontaneously appearing - , and disappearing thrombophlebitis

Question 12

Associated malignancies of migratory thrombophlebitis

Answer 12

1. Most common in pancreas cancer
2. Carcinoma lung
3. GI track malignancies
4. Prostate, ovary cancer
5. Lymphoma

Question 13

Trousseau’s sign

Answer 13

Carpopedal spasm in hypocalcomia

Question 14

Troisier’s sign

Answer 14

Palpable left supra clavicular lymph node /Virchow’s node

Question 15

Gold standard tumor marker

Answer 15

Ca-19 -9