Intraductal papillary mucinous neoplasm

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Intraductal papillary mucinous neoplasm
IPMN T2w ax-07 a.jpg
Synonyms IPMN
Pronounce N/A
Specialty N/A
Symptoms Abdominal pain, jaundice, pancreatitis
Complications Pancreatic cancer, diabetes mellitus
Onset Typically in middle age to elderly
Duration Chronic
Types Main duct, branch duct, mixed type
Causes Unknown
Risks Smoking, chronic pancreatitis, genetic predisposition
Diagnosis MRI, EUS, CT scan, biopsy
Differential diagnosis Pancreatic cyst, mucinous cystic neoplasm, serous cystadenoma
Prevention Regular monitoring, lifestyle changes
Treatment Surgical resection, surveillance
Medication None specific
Prognosis Varies; risk of malignancy
Frequency Increasing with age
Deaths Related to progression to cancer


Histopathology of intraductal papillary mucinous neoplasm types
Relative incidence of pancreatic neoplasms

Intraductal papillary mucinous neoplasm (IPMN) is a type of pancreatic cyst that can develop into pancreatic cancer. It is characterized by the growth of mucus-producing cells in the pancreatic ducts.

Introduction

IPMN is a precancerous lesion that arises from the pancreas, a vital organ that plays essential roles in digestion and hormone production. The pancreas is composed of exocrine and endocrine cells. The exocrine cells produce enzymes that aid in digestion, while the endocrine cells produce hormones like insulin. In IPMN, the exocrine cells, specifically those lining the pancreatic ducts, start to proliferate abnormally, leading to the formation of cysts filled with mucus.

Types

There are two main types of IPMN: main duct IPMN and branch duct IPMN. Main duct IPMN involves the main pancreatic duct, while branch duct IPMN involves the smaller side branches. Main duct IPMN is more likely to progress to cancer than branch duct IPMN.

Symptoms

Symptoms of IPMN can vary and often depend on the location and size of the cysts. Common symptoms include abdominal pain, nausea, vomiting, weight loss, and jaundice. However, many people with IPMN do not have any symptoms, and the condition is often discovered incidentally during imaging tests for other conditions.

Diagnosis

Diagnosis of IPMN typically involves imaging tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI), and endoscopic ultrasound. In some cases, a sample of the cyst fluid may be taken for analysis, a procedure known as fine-needle aspiration.

Treatment

The treatment for IPMN depends on several factors, including the type of IPMN, the size of the cysts, the presence of symptoms, and the overall health of the patient. Options may include surveillance, surgical removal of the cysts, or total pancreatectomy in severe cases.

Prognosis

The prognosis for IPMN varies depending on the type and stage of the disease. Early detection and treatment can significantly improve the prognosis.

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Contributors: Prab R. Tumpati, MD