Pancreatic cystic tumors

Question 1

What are the main types of pancreatic cystic tumors: (3)

Answer 1

mucinous (MCN)
serous (SCN)
Intraductal papillary mucinous neoplasm (IPMN)

Question 2

MCN- M___ is in the M___ of the pancreas

Answer 2

mucinous

middle

Question 3

MCN can be ___ or ___ and is the most common ___tumor

Answer 3

malignant
benign
cystic

Question 4

MCN is __ times more common in young ___

Answer 4

10

women

Question 5

MCN is usually found in the __ or ___ of the pancreas

Answer 5

head

tail

Question 6

What are the 3 ways to diagnose pancreatitis:

Answer 6

CT
FNA/EUS
histology

Question 7

What are the CT features indicating malignancy of the pancreas? (3)

Answer 7

large mass
eggshell calcification
mural nodule

Question 8

EUS or FNA that will show ___ rich fluid and high levels of __ markers are suggestive for pancreatic cancer. remember __ will be negative (unlike ___ or __)

Answer 8

mucin
CEA
amylase
IPMN
pseudocyst

Question 9

When suspecting pancreatic cancer, ___ is not required. If taken, we should look for ___ secreting epithelial cells, and ___ like stroma tissue.

Answer 9

biopsy
mucin
ovary

Question 10

Treating MCN requires ___ resection of the involved area.
If the finding is benign- >____
If the finding is malignant -> __ therapy with -% survival for 5 years.

Answer 10

pancreatic
no follow up
adjuvant
50-60

Question 11

SCN is a ___ mass appearing as a single finding at the __ of the pancreas

Answer 11

cystic

head

Question 12

SCN is more common at ___ ages

Answer 12

older

Question 13

SCN- in most cases the mass is ___ and the clinical signs include ___ abdominal pain, ___ loss, and obstructive ___.

Answer 13

benign
dull
weight
jaundice

Question 14

Macroscopically SCN is usually very ___ with defined borders.
Microscopically there are multi loculation filled with ___

Answer 14

large

glycogen

Question 15

What is the classical CT sign in SCN?

Answer 15

Sunburst appearance

Question 16

When SCN is symptomatic/>4 cm/ unclear diagnosis -> treat with ___

Answer 16

Whipple

Question 17

IPMN is more common at the ages of - and is classified by the level of penetration to the pancreatic ___

Answer 17

50-60

duct

Question 18

What are the 3 types of IPMN?

1) ____ (BD-IPMN)
2) ___ duct (MD-IPMN)
3) ___ IPMN

Answer 18

side branch/ branch duct
main
mixed

Question 19

The classic characteristic feature of main duct IPMN is thick ___ secretion oozing from the ___ papillary

Answer 19

mucin

Vater

Question 20

IPMN= ____

Answer 20

Intraductal papillary mucinous neoplasm

Question 21

MD-IPMN has a ___ malignancy potential, with -% chance for __, therefor when diagnose we must ___

Answer 21

high
30-50
AC
operate

Question 22

Most MD-IPMN patients are symptomatic and suffer from __ pain (50%), and ___ (25%)

Answer 22

abdominal pain

pancreatitis

Question 23

Mention 5 MD-IPMN malignancy predictors:
Dilated virsong \_\_> mm
\_\_ nodule
\_\_
elevated \_\_
\_\_

Answer 23

7
mural
diabetes
ALK-P
jaundice

Question 24

Diagnosing MD-IPMN is made primarily with __, but __ and __ are also useful

Answer 24

CT
EUS
MRCP

Question 25

MD-IPMN will produce __ markers and elevated ___

Answer 25

CEA

amylase

Question 26

The surgery of choice in IPMN is ___

Answer 26

partial pancreatectomy

Question 27

We must remember IPMN is associated with __ pancreatic malignancies in 1/3 of cases. Especially __ and __. Therefor diagnosis requires the following steps: __ and __

Answer 27

extra
stomach 
colon
gastroscopy
colonoscopy