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Morphologic Changes in Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Midterm Follow-Up Study  Pierre—Emmanuel Rautou, Phillippe.

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Presentation on theme: "Morphologic Changes in Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Midterm Follow-Up Study  Pierre—Emmanuel Rautou, Phillippe."— Presentation transcript:

1 Morphologic Changes in Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Midterm Follow-Up Study  Pierre—Emmanuel Rautou, Phillippe Lévy, Marie–Pierre Vullierme, Dermot O'Toole, Anne Couvelard, Dominique Cazals–Hatem, Laurent Palazzo, Alain Aubert, Alain Sauvanet, Pascal Hammel, Olivia Hentic, Vinciane Rebours, Anne–Laure Pelletier, Frédérique Maire, Phillippe Ruszniewski  Clinical Gastroenterology and Hepatology  Volume 6, Issue 7, Pages (July 2008) DOI: /j.cgh Copyright © 2008 AGA Institute Terms and Conditions

2 Figure 1 IPMN confined to branch ducts. (A) CT scan shows calcifications (arrow) in the pancreatic head. (B) MRCP image shows branch duct dilatation in the head, body, and tail of the pancreas. Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

3 Figure 2 Unilocular IPMN confined to BDs in the body of the pancreas. Within 1 year, MRCP showed a cyst size increase from (A) 19 mm to (B) 34 mm. Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

4 Figure 3 EUS shows wall thickening (4–5 mm) in a dilated BD IPMN of the pancreatic head communicating with the main pancreatic duct. (Asterisk), Hepatic artery; (PV), portal vein; (GB), gallbladder; (white arrow), wall thickening; (white arrowhead), mural nodule. Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

5 Figure 4 IPMN confined to BDs in the body of the pancreas. (A) EUS at diagnosis. (B) EUS 1 year after diagnosis. Within 1 year, EUS images showed the development of a mural nodule (white arrow). Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

6 Figure 5 Algorithm showing the fate of 121 patients with IPMN confined to BD. CIS, carcinoma in situ. Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

7 Figure 6 Histologic features of IPMN confined to BD. (A) IPMN-adenoma: tumors with no or low cytoarchitectural atypias (hemalin eosin safran coloration, magnification, 40×); (B) borderline-IPMN: tumors with moderate cytoarchitectural atypias (hemalin eosin safran coloration, magnification, 40×); and (C) IPMN-carcinoma in situ: tumors with frank intraepithelial malignancy (hemalin eosin safran coloration, magnification, 80×). Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions

8 Figure 7 Cumulative risk of developing signs suggesting malignancy in patients with cyst size increase (dashed line) or stable cyst size (plain line). Kaplan–Meier method. Comparison by log-rank test. Clinical Gastroenterology and Hepatology 2008 6, DOI: ( /j.cgh ) Copyright © 2008 AGA Institute Terms and Conditions


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