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Published in: Endocrine Pathology 1/2013

01-03-2013

Intraductal Polypoid Lipid-Rich Neuroendocrine Tumor of the Pancreas with Entrapped Ductules: Case Report and Review of the Literature

Authors: Jaclyn Frances Hechtman, Bernardo Franssen, Daniel M. Labow, Ronald E. Gordon, Christopher J. DiMaio, Eric J. Wilck, Gonzalo Carrasco-Avino, Hongfa Zhu

Published in: Endocrine Pathology | Issue 1/2013

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Abstract

Pancreatic neuroendocrine tumors of the main pancreatic duct are rare and usually small due to symptoms of pancreatic duct obstruction. We present a case of a large (3 cm), well-differentiated (G1) lipid-rich polypoid neuroendocrine tumor of the pancreas completely occluding the main pancreatic duct with non-neoplastic-entrapped ductules and CK19 positivity. Clinical, radiological, gross, microscopic, immunohistochemical, and ultrastructural findings are discussed. The literature pertaining to the unique features of this case is reviewed including clinical and pathologic pitfalls and the possible etiologic and prognostic significance of these findings.
Literature
1.
go back to reference Albores-Saavedra J, Henson D, Klimstra D. Tumors of the gallbladder, extrahepatic biliary ducts and ampulla of vater. AFIP Atlas of Tumor Pathology, 3rd ser. Washington, DC: Armed Forces Institute of Pathology, 2000. Albores-Saavedra J, Henson D, Klimstra D. Tumors of the gallbladder, extrahepatic biliary ducts and ampulla of vater. AFIP Atlas of Tumor Pathology, 3rd ser. Washington, DC: Armed Forces Institute of Pathology, 2000.
2.
go back to reference Walter T, Hervieu V, Adham M, et al. Primary neuroendocrine tumors of the main pancreatic duct: a rare entity. Virchows Arch 2011;458(5):537–546.PubMedCrossRef Walter T, Hervieu V, Adham M, et al. Primary neuroendocrine tumors of the main pancreatic duct: a rare entity. Virchows Arch 2011;458(5):537–546.PubMedCrossRef
3.
go back to reference Nagai E, Yamaguchi K, Hashimoto H, Sakurai T. Carcinoid tumor of the pancreas with obstructive pancreatitis. Am J Gastroenterol 1993;87:361–364. Nagai E, Yamaguchi K, Hashimoto H, Sakurai T. Carcinoid tumor of the pancreas with obstructive pancreatitis. Am J Gastroenterol 1993;87:361–364.
4.
go back to reference Dei Tos AP, Laurino L, De Boni M, Doglioni C. Preoperative cytodiagnosis of primitive carcinoid tumor of the Wirsung duct: a case report with immunocytochemical study. Diagn Cytopathol 1993;9:471–474.PubMedCrossRef Dei Tos AP, Laurino L, De Boni M, Doglioni C. Preoperative cytodiagnosis of primitive carcinoid tumor of the Wirsung duct: a case report with immunocytochemical study. Diagn Cytopathol 1993;9:471–474.PubMedCrossRef
5.
go back to reference Sarles H, Cambon P, Choux R, et al. Chronic obstructive pancreatitis due to tiny (0.6 to 8 mm) benign tumors obstructing pancreatic ducts: report of three cases. Pancreas 1988;3:232–237.PubMedCrossRef Sarles H, Cambon P, Choux R, et al. Chronic obstructive pancreatitis due to tiny (0.6 to 8 mm) benign tumors obstructing pancreatic ducts: report of three cases. Pancreas 1988;3:232–237.PubMedCrossRef
6.
go back to reference Kim HC, Park SI, Park SJ, et al. Pancreatic carcinoid tumor with obstructive pancreatitis: multislice helical CT appearance: case report. Abdom Imaging 2005;30:601–604PubMedCrossRef Kim HC, Park SI, Park SJ, et al. Pancreatic carcinoid tumor with obstructive pancreatitis: multislice helical CT appearance: case report. Abdom Imaging 2005;30:601–604PubMedCrossRef
7.
go back to reference Hamada Y, Nakayama Y, Maeshiro K, Ikeda T, Hayashi H, Iwasaki H. Two cases of primary carcinoid tumor of the pancreas associated with marked stenosis of the main pancreatic duct. Pancreas 2009;38:834–835.PubMedCrossRef Hamada Y, Nakayama Y, Maeshiro K, Ikeda T, Hayashi H, Iwasaki H. Two cases of primary carcinoid tumor of the pancreas associated with marked stenosis of the main pancreatic duct. Pancreas 2009;38:834–835.PubMedCrossRef
8.
go back to reference Terada T, Kawaguchi M, Furukawa K, Sekido Y, Osamura Y. Minute mixed ductal-endocrine carcinoma of the pancreas with predominant intraductal growth. Pathol Int 2002;52(11):740–746.PubMedCrossRef Terada T, Kawaguchi M, Furukawa K, Sekido Y, Osamura Y. Minute mixed ductal-endocrine carcinoma of the pancreas with predominant intraductal growth. Pathol Int 2002;52(11):740–746.PubMedCrossRef
9.
go back to reference Chetty R, El-Shinnawy I. Intraductal pancreatic neuroendocrine tumor. Endocr Pathol 2009;20(4):262–266.PubMedCrossRef Chetty R, El-Shinnawy I. Intraductal pancreatic neuroendocrine tumor. Endocr Pathol 2009;20(4):262–266.PubMedCrossRef
10.
go back to reference Maitra A, Krueger JE, Tascilar M, et al. Carcinoid tumors of the extrahepatic bile ducts: a study of seven cases. Am J Surg Pathol 2000;24(11):1501–1510.PubMedCrossRef Maitra A, Krueger JE, Tascilar M, et al. Carcinoid tumors of the extrahepatic bile ducts: a study of seven cases. Am J Surg Pathol 2000;24(11):1501–1510.PubMedCrossRef
11.
go back to reference Lee JH, Lee KG, Oh YH, Paik SS, Park HK, Lee KS. Carcinoid tumors of the extrahepatic biliary tract: report of four cases. Surg Today 2011;41(3):430–435.PubMedCrossRef Lee JH, Lee KG, Oh YH, Paik SS, Park HK, Lee KS. Carcinoid tumors of the extrahepatic biliary tract: report of four cases. Surg Today 2011;41(3):430–435.PubMedCrossRef
12.
go back to reference Dahms BB, Lippe BM, Dakake C, Fonkalsrud EW, Mirra JM. The occurrence in a neonate of a pancreatic adenoma with nesidioblastosis in the tumor. Am J Clin Pathol 1976;65(4):462–466.PubMed Dahms BB, Lippe BM, Dakake C, Fonkalsrud EW, Mirra JM. The occurrence in a neonate of a pancreatic adenoma with nesidioblastosis in the tumor. Am J Clin Pathol 1976;65(4):462–466.PubMed
13.
go back to reference Van Eeden S, de Leng WW, Offerhaus GJ, et al. Ductuloinsular tumors of the pancreas: endocrine tumors with entrapped non neoplastic ductules. Am J Surg Pathol 2004;28(6):813–820.PubMedCrossRef Van Eeden S, de Leng WW, Offerhaus GJ, et al. Ductuloinsular tumors of the pancreas: endocrine tumors with entrapped non neoplastic ductules. Am J Surg Pathol 2004;28(6):813–820.PubMedCrossRef
14.
go back to reference Chetty R, Serra S, Asa SL, Adsay VN. Pancreatic endocrine tumour with ductules: further observations of an unusual histological subtype. Pathology 2006;38(1):5–9.PubMedCrossRef Chetty R, Serra S, Asa SL, Adsay VN. Pancreatic endocrine tumour with ductules: further observations of an unusual histological subtype. Pathology 2006;38(1):5–9.PubMedCrossRef
15.
go back to reference Singh R, Basturk O, Klimstra DS, et al. Lipid-rich variant of pancreatic endocrine neoplasms. Am J Surg Pathol 2006;30(2):194–200.PubMedCrossRef Singh R, Basturk O, Klimstra DS, et al. Lipid-rich variant of pancreatic endocrine neoplasms. Am J Surg Pathol 2006;30(2):194–200.PubMedCrossRef
16.
go back to reference Lubensky IA, Pack S, Ault D, et al. Multiple neuroendocrine tumors of the pancreas in von Hippel–Lindau disease. Am J Pathol 1998;153:223–231.PubMedCrossRef Lubensky IA, Pack S, Ault D, et al. Multiple neuroendocrine tumors of the pancreas in von Hippel–Lindau disease. Am J Pathol 1998;153:223–231.PubMedCrossRef
17.
go back to reference Fryer E, Serra S, Chetty R. Lipid-rich ("clear cell") neuroendocrine tumors of the pancreas in MEN I patients. Endocr Pathol 2012; 23(4):243–246PubMedCrossRef Fryer E, Serra S, Chetty R. Lipid-rich ("clear cell") neuroendocrine tumors of the pancreas in MEN I patients. Endocr Pathol 2012; 23(4):243–246PubMedCrossRef
18.
go back to reference Chetty R, Serra S. Lipid-rich and clear cell neuroendocrine tumors (“carcinoid”) of the appendix: potential confusion with goblet cell carcinoid. Am J Surg Pathol 2010;34:401–404.PubMedCrossRef Chetty R, Serra S. Lipid-rich and clear cell neuroendocrine tumors (“carcinoid”) of the appendix: potential confusion with goblet cell carcinoid. Am J Surg Pathol 2010;34:401–404.PubMedCrossRef
19.
go back to reference Carlei F, Barsotti P, Crescenzi A, et al. Neuroendocrine epithelial cells of the main pancreatic ducts and ampulla. Ital J Gastroenterol 1993;25:171–173.PubMed Carlei F, Barsotti P, Crescenzi A, et al. Neuroendocrine epithelial cells of the main pancreatic ducts and ampulla. Ital J Gastroenterol 1993;25:171–173.PubMed
20.
go back to reference McCall CM, Shi C, Klein AP, et al. Serotonin expression in pancreatic neuroendocrine tumors correlates with a trabecular histologic pattern and large duct involvement. Hum Pathol 2012;43(8):1169–1176.PubMedCrossRef McCall CM, Shi C, Klein AP, et al. Serotonin expression in pancreatic neuroendocrine tumors correlates with a trabecular histologic pattern and large duct involvement. Hum Pathol 2012;43(8):1169–1176.PubMedCrossRef
21.
go back to reference Schmitt AM, Anlauf M, Rousson V, et al. WHO 2004 criteria and CK19 are reliable prognostic markers in pancreatic endocrine tumors. Am J Surg Pathol 2007;31(11):1677–1682.PubMedCrossRef Schmitt AM, Anlauf M, Rousson V, et al. WHO 2004 criteria and CK19 are reliable prognostic markers in pancreatic endocrine tumors. Am J Surg Pathol 2007;31(11):1677–1682.PubMedCrossRef
22.
go back to reference Ali A, Serra S, Asa SL, Chetty R. The predictive value of CK19 and CD99 in pancreatic endocrine tumors. Am J Surg Pathol 2006;30(12):1588–194.PubMedCrossRef Ali A, Serra S, Asa SL, Chetty R. The predictive value of CK19 and CD99 in pancreatic endocrine tumors. Am J Surg Pathol 2006;30(12):1588–194.PubMedCrossRef
23.
go back to reference Zhang L, Lohse CM, Dao LN, Smyrk TC. Proposed histopathologic grading system derived from a study of KIT and CK19 expression in pancreatic endocrine neoplasm. Hum Pathol 2011;42(3):324–331.PubMedCrossRef Zhang L, Lohse CM, Dao LN, Smyrk TC. Proposed histopathologic grading system derived from a study of KIT and CK19 expression in pancreatic endocrine neoplasm. Hum Pathol 2011;42(3):324–331.PubMedCrossRef
24.
go back to reference Li J, Goodyer CG, Fellows F, et al. Stem cell factor/c-Kit interactions regulate human islet-epithelial cluster proliferation and differentiation. Int J Biochem Cell Biol 2006;38:961–972.PubMedCrossRef Li J, Goodyer CG, Fellows F, et al. Stem cell factor/c-Kit interactions regulate human islet-epithelial cluster proliferation and differentiation. Int J Biochem Cell Biol 2006;38:961–972.PubMedCrossRef
25.
go back to reference Barron-Rodriguez LP, Manivel JC, Mendez-Sanchez N, Jessurun J. Carcinoid tumor of the common bile duct: evidence for its origin in metaplastic endocrine cells. Am J Gastroenterol 1991;86:1073–1106.PubMed Barron-Rodriguez LP, Manivel JC, Mendez-Sanchez N, Jessurun J. Carcinoid tumor of the common bile duct: evidence for its origin in metaplastic endocrine cells. Am J Gastroenterol 1991;86:1073–1106.PubMed
Metadata
Title
Intraductal Polypoid Lipid-Rich Neuroendocrine Tumor of the Pancreas with Entrapped Ductules: Case Report and Review of the Literature
Authors
Jaclyn Frances Hechtman
Bernardo Franssen
Daniel M. Labow
Ronald E. Gordon
Christopher J. DiMaio
Eric J. Wilck
Gonzalo Carrasco-Avino
Hongfa Zhu
Publication date
01-03-2013
Publisher
Springer US
Published in
Endocrine Pathology / Issue 1/2013
Print ISSN: 1046-3976
Electronic ISSN: 1559-0097
DOI
https://doi.org/10.1007/s12022-012-9231-x

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