Variant of intraductal carcinoma (with scant mucin production) is of main pancreatic duct origin: a clinicopathological study of four patients.

Abstract

To investigate the histopathological and immunohistochemical features of intraductal "nodular" tumor located in the main pancreatic duct. Four cases were studied, and the results were compared with those in 10 cases of common ductal adenocarcinomas of the pancreas. The intraductal nodular carcinoma were large, more than 3 cm in diameter (range, 3-7 cm), lacked macroscopic mucin production, and presented a papillotubular adenocarcinoma. These tumors showed minimal invasion into the periductal tissue, duodenum, and choledochus. Immunohistochemically, the tumor cells were negative for anti-CEA and faintly positive for anti-CA19-9, in all except one tumor, whereas the common ductal adenocarcinomas were clearly positive for both. The postoperative course was favorable, and all three living patients remained healthy for more than 4 yr. These tumors may be variants of intraductal tumors with a more favorable prognosis.