Abstract

Mucinous cystic neoplasms (MCNs) of the pancreas are rare, mucin-producing cystic tumors. Generally, pancreatic MCNs occur mostly in middle-aged women and are located in the body and the tail of the pancreas. MCNs can be unilocular or multilocular cystic tumors with fibrous capsules and cysts, and are filled with mucinous fluid. Histologically, these cysts are lined by a tall columnar and mucin-secreting epithelium with various grades of atypia. A cellular stroma composed of spindle cells, known as ovarian-like stroma (OLS), is observed in the cyst wall and septum. Immunohistologicaly, OLS shows positivity for vimentin and a-smooth muscle actin and strong nuclear staining with estrogen and progesterone receptor. The aim of this study is to clarify the clinicopathologic features of pancreatic MCNs, especially the OLS and diacrisis from intraductal papillary-mucinous neoplasms.

Copyright © 2007 S. Karger AG, Basel

Mucinous cystic neoplasms (MCNs) are rare but well-known disease entities that occur in the pancreas, liver, and the retroperitoneum [1, 2]. MCNs of the pancreas are mucin-producing unilocular or multilocular cystic tumors with a fibrous capsule and are lined by mucin-secreting epithelium associated with an underlying subepithelial ovarian-like stroma (OLS). OLS is the subepithelial component resembling the ovarian stroma, that is composed of bundles of densely packed spindle cells. Immunohistologically, the OLS shows strong positivity for a-smooth muscle actin (SMA) and vimentin, and weak, focal positivity for desmin [3]. Both estrogen receptors (ER) and progesterone receptors (PgR) are expressed in the nuclei of OLS cells. The grade of dysplastic changes should be classified as slight (mild), moderate, and severe. In accordance with the

World Health Organization (WHO) classification, also reported in the Armed Forces Institute of Pathology (AFIP) fascicle, pancreatic MCNs are divided into adenomas, borderline tumors, and non-invasive and invasive carcinomas.

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