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Colloid Carcinoma Arising in an Intestinal-Type Intraductal Papillary Mucinous Neoplasm with High-Grade Dysplasia Appearing as Signet-Ring Cells of the Pancreas by Serial Pancreatic Juice Aspiration Cytology: A Case Report

Version 1 : Received: 5 September 2023 / Approved: 6 September 2023 / Online: 7 September 2023 (10:45:29 CEST)

A peer-reviewed article of this Preprint also exists.

Tachibana, M.; Hirota, T.; Hamayasu, H.; Takeuchi, Y.; Tsukamoto, K.; Matsushita, M. Colloid Carcinoma Arising in an Intestinal-Type Intraductal Papillary Mucinous Neoplasm with High-Grade Dysplasia Appearing as Signet-Ring Cells of the Pancreas by Serial Pancreatic Juice Aspiration Cytology: A Case Report. Diagnostics 2023, 13, 3123. Tachibana, M.; Hirota, T.; Hamayasu, H.; Takeuchi, Y.; Tsukamoto, K.; Matsushita, M. Colloid Carcinoma Arising in an Intestinal-Type Intraductal Papillary Mucinous Neoplasm with High-Grade Dysplasia Appearing as Signet-Ring Cells of the Pancreas by Serial Pancreatic Juice Aspiration Cytology: A Case Report. Diagnostics 2023, 13, 3123.

Abstract

We report a case of colloid carcinoma (CC) arising from an intestinal-type intraductal papillary mucinous neoplasm with high-grade dysplasia (IPMNHGD) of the pancreas, diagnosed with serial pancreatic juice aspiration cytological examination (SPACE). A rapidly growing intraductal papillary mucinous neoplasm (IPMN) in a 71-year-old Japanese man accelerated his hospitalization in our institute. Clinically, a large, ruptured pancreatic cyst was suspected. Cytologically, several mucin-positive signet-ring cells were scattered in the inflammatory, necrotic, or mucinous background. Signet-ring cells in cell block specimens were immunoreactive for MUC2, MUC5AC, maspin, S100P, and claudin-18. The final cytologic diagnosis was CC arising in an intestinal-type IPMNHGD with intraperitoneal penetration. The patient died two months postoperatively. The cytologic diagnosis was achieved through SPACE, and the presence of signet-ring cells was characteristic. Anti-claudin-18.2-specific monoclonal antibody therapy will likely be used to treat patients with IPMNHGD in the future. To our knowledge, this is the first report in English on mucin-positive signet-ring cells of CC arising in an intestinal-type IPMNHGD evaluated by SPACE cytology.

Keywords

claudin-18; cytopathology; colloid carcinoma (CC) of the pancreas; intraductal papillary mucinous neoplasm with high-grade dysplasia (IPMNHGD) of the pancreas; signet-ring cell; serial pancreatic juice aspiration cytological examination (SPACE)

Subject

Medicine and Pharmacology, Pathology and Pathobiology

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