TY - JOUR
T1 - An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms
AU - Hruban, Ralph H.
AU - Takaori, Kyoichi
AU - Klimstra, David S.
AU - Adsay, N. Volkan
AU - Albores-Saavedra, Jorge
AU - Biankin, Andrew V.
AU - Biankin, Sandra A.
AU - Compton, Carolyn
AU - Fukushima, Noriyoshi
AU - Furukawa, Toru
AU - Goggins, Michael
AU - Kato, Yo
AU - Kloppel, Gunter
AU - Longnecker, Daniel S.
AU - Luttges, Jutta
AU - Maitra, Anirban
AU - Offerhaus, G. Johan A.
AU - Shimizu, Michio
AU - Yonezawa, Suguru
PY - 2004/8/1
Y1 - 2004/8/1
N2 - Invasive pancreatic ductal adenocarcinoma is an almost uniformly fatal disease. Several distinct noninvasive precursor lesions can give rise to invasive adenocarcinoma of the pancreas, and the prevention, detection, and treatment of these noninvasive lesions offers the potential to cure early pancreatic cancers. Noninvasive precursors of invasive ductal adenocarcinoma of the pancreas include pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms. Diagnostic criteria, including a distinct ovarian-type stroma, and a consistent nomenclature are well established for mucinous cystic neoplasms. By contrast, consistent nomenclatures and diagnostic criteria have been more difficult to establish for PanINs and IPMNs. Because both PanINs and IPMNs consist of intraductal neoplastic proliferations of columnar, mucin-containing cells with a variable degree of papilla formation, the distinction between these two classes of precursor lesions remains problematic. Thus, considerable ambiguities still exist in the classification of noninvasive neoplasms in the pancreatic ducts. A meeting of international experts on precursor lesions of pancreatic cancer was held at The Johns Hopkins Hospital from August 18 to 19, 2003. The purpose of this meeting was to define an international acceptable set of diagnostic criteria for PanINs and IPMNs and to address a number of ambiguities that exist in the previously reported classification systems for these neoplasms. We present a consensus classification of the precursor lesions in the pancreatic ducts, PanINs and IPMNs.
AB - Invasive pancreatic ductal adenocarcinoma is an almost uniformly fatal disease. Several distinct noninvasive precursor lesions can give rise to invasive adenocarcinoma of the pancreas, and the prevention, detection, and treatment of these noninvasive lesions offers the potential to cure early pancreatic cancers. Noninvasive precursors of invasive ductal adenocarcinoma of the pancreas include pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms. Diagnostic criteria, including a distinct ovarian-type stroma, and a consistent nomenclature are well established for mucinous cystic neoplasms. By contrast, consistent nomenclatures and diagnostic criteria have been more difficult to establish for PanINs and IPMNs. Because both PanINs and IPMNs consist of intraductal neoplastic proliferations of columnar, mucin-containing cells with a variable degree of papilla formation, the distinction between these two classes of precursor lesions remains problematic. Thus, considerable ambiguities still exist in the classification of noninvasive neoplasms in the pancreatic ducts. A meeting of international experts on precursor lesions of pancreatic cancer was held at The Johns Hopkins Hospital from August 18 to 19, 2003. The purpose of this meeting was to define an international acceptable set of diagnostic criteria for PanINs and IPMNs and to address a number of ambiguities that exist in the previously reported classification systems for these neoplasms. We present a consensus classification of the precursor lesions in the pancreatic ducts, PanINs and IPMNs.
KW - Adenocarcinoma
KW - Diagnosis
KW - Intraductal papillary mucinous neoplasm (IPMN)
KW - Pancreatic intraepithelial neoplasia (PanIN)
UR - http://www.scopus.com/inward/record.url?scp=3242744313&partnerID=8YFLogxK
U2 - 10.1097/01.pas.0000126675.59108.80
DO - 10.1097/01.pas.0000126675.59108.80
M3 - Article
C2 - 15252303
AN - SCOPUS:3242744313
SN - 0147-5185
VL - 28
SP - 977
EP - 987
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 8
ER -