Fine Needle Aspiration Cytology of Noninvasive Ductal Carcinomas of the Pancreas

Abstract

Invasive ductal adenocarcinoma (IDA) of the pancreas (IDAP) originating from the ductal gland has a poor prognosis worldwide. To improve the prognosis, treatment for noninvasive carcinoma stages is needed. Noninvasive carcinomas are principally intraductal papillary- mucinous carcinomas (IPMC) and pancreatic intraepithelial neoplasm 3 (PanIN-3). Small papillary-cohesive clusters, with mainly small regular (about 10
m) nuclei, clearly defined cell borders, a mixture of some goblet cells, and a monoclonal aspect are cytologically observed in both IPMC and IPMN, while euchromatin and nuclei malignancy are observed only in IPMC. PanIN-3 cells have small papillary-cohesive and compact clusters, dense and meager cytoplasm without prominent anisocytosis and without cytoplasm 21
m at the shortest diameter. The nuclei are individually well enveloped in well preserved cytoplasm separately from each other, and are small regular nuclei mostly highly suspicious for malignancy. IDA cells have loose sheet-solid clusters, poorly preserved cytoplasm, nuclei that tend to adhere to each other, a combination of large nuclei (short diameter 15
m) with hyperchromatin, and a monoclonal aspect. To preoperatively differentiate noninvasive IPMC/PanIN-3 from IDAP, these would be clinically very useful.