Pancreatic cysts
Name the 3 types of mucinous cysts
IPMN, mucinous cystic neoplasms (MCNs), nondysplastic mucinous cysts (NDMCs)
Enzyme used as a tumor marker in acinar cell carcinoma
Lipase
Anatomic subtypes of IPMN
Main duct (MD-IPMN), branched duct (BD-IPMN) or mixed type
Name the high-risk stigmata of IPMN
Enhancing solid component, main duct size >= 10mm, obstructive jaundice
Treatment of autoimmune pancreatitis
Corticosteroids
Defining pathologic feature of mucinous cystic neoplasm
Ovarian-type stroma
Classic imaging finding of primary pancreatic lymphoma
Bulky lesion with considerable local lymphadenopathy in head of pancreas
Histologic subtypes of IPMN
Gastric, intestinal, pancreaticobiliary, oncocytic
Pathognomonic endoscopic feature of IPMN
Enlarged ampulla or “fish-mouth” sign
Most common cancer to metastasize to pancreas
Renal cell carcinoma
Characteristic imaging findings of serous cystadenoma
“starburst” pattern
“ground-glass,” “cluster-of-grapes,” or “honeycomb” appearance
Tumor that has potential to spread to liver and peritoneal cavity
Solid pseudopapillary neoplasm
Most common MD-IPMN subtype
Intestinal
Name 3 of worrisome features of IPMN
Size >3cm, thickened enhancing cyst walls, main pancreatic duct 5-9mm, none-enhancing mural nodule, abrupt change in caliber of pancreatic duct with distal pancreatic atrophy
IPMN histologic subtype found in uncinate process
Gastric
How does macrocystic serous cystadenoma differ from conventional SCA?
Larger, more discrete cystic cavities separated by obvious septae
What are the features of Schmid’s triad?
Polyarthralgia, eosinophilia, subcutaneous fat necrosis
Subtype with greatest likelihood of malignancy
Pancreaticobiliary
Management of patient with worrisome features and inconclusive EUS
Surveillance every 3-6 months with alternating MRI and EUS
IPMN histologic subtype with complex papillae and eosinophilic cytoplasm
Oncocytic
What feature leads mucinous cystic neoplasms to be mistaken for pseudocysts?
Cystic wall containing calcifications
What is first line therapy for primary pancreatic lymphoma?
Systemic chemotherapy with CHOP (cyclophosphamide, hydroxydoxorubicin, oncovin, prednisone)
Histologic subtype that expresses scattered MUC2 and MUC6 but not MUC1
Gastric
Surveillance of patient following resection of invasive carcinoma
CT every 3 months for first 1-2 years, then every 6 months
Histological characteristics of type 2 autoimmune pancreatitis