IPMN and other cystic pancreas

Question 1

histology finding of IPMN

Answer 1

mucin producing columnar cells

Question 2

histology finding of MCN

Answer 2

ovarian like stroma (also mucin producing)

Question 3

IPMN malignancy risk of main duct

Answer 3

~70%

Question 4

malignancy risk of side duct IPMN

Answer 4

20% at 10 years.

Question 5

CR/MRI finding of pancreas cyst concerning for malignancy

Answer 5

mural nodules, especially >3mm

Question 6

Initial criteria for resection of “IPMN”

Answer 6

Any main duct (>1cm)
any solid component
obstructive jaudice
other symptoms

Question 7

borderline criteria to consider EUS/FNA for “IPMN”

Answer 7

size>30mm
wall thickening
non-enhancing mural nodule
associated pancreatitis
main duct 5-9mm
Abrupt change in the main pancreating duct with distal atrophy

Question 8

What percent of pancreatic cyst FNAs are non-diagnostic?

Answer 8

~50% are non-diagnostic (acellular); tumor markers are under study