Clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas

A clinicopathologic study of three cases and review of the literature

Punam Bhanot, William H. Nealon, Eric Walser, Manoop S. Bhutani, Wendell W. Tang, Roberto Logroño

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Solid pseudopapillary tumors are rare pancreatic neoplasms of uncertain pathogenesis that rarely metastasize and usually occur in young women. We describe the clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas. We reviewed the clinical presentation, imaging, morphologic/immunochemical features, and follow-up of three women (age range 26-44). Cases 1, 2, and 3 presented with abdominal wall abscess, multiple endocrine neoplasia, and solid/cystic mass in the pancreatic head, respectively, and computed tomography of abdomen revealed solid/cystic masses with heterogeneous enhancement in body, tail and head of the pancreas, respectively. Case 2 also exhibited a left adrenal mass. Case 3 underwent endoscopic ultrasound of the pancreas, which showed a complex solid/cystic mass with septations. Sampling consisted of fine-needle aspiration (percutaneous or endosonography-guided), and additionally, core biopsy of the pancreatic mass and adrenal lesion in case 2. Aspirates and core biopsy revealed vascular structures with attached monotonous neoplastic cells in papillary-like arrays. Tumor cells had bland nuclear features with grooves, cytoplasmic periodic acid Schiff-positive hyaline globules, and associated myxoid/stromal fragments. Immunochemistry expressed α-1-antitrypsin, α-1-antichymotrypsin, vimentin, and focal neuron-specific enolase. Cases 1 and 3 underwent pancreatectomy with follow-up consisting of yearly imaging and no recurrences. Case 2 proved metastatic disease to adrenal gland and no follow-up was available. In the setting of typical clinical and imaging findings, an accurate preoperative diagnosis of pancreatic solid pseudopapillary tumor can be established by aspiration cytology and immunochemistry with or without concomitant core biopsy, on the basis of which clinicians decide treatment. This tumor can behave in a malignant fashion.

Original languageEnglish (US)
Pages (from-to)421-428
Number of pages8
JournalDiagnostic Cytopathology
Volume33
Issue number6
DOIs
StatePublished - Dec 2005

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Pancreas
Immunochemistry
Neoplasms
Biopsy
Adrenal Gland Diseases
Multiple Endocrine Neoplasia
Abdominal Abscess
Endosonography
Periodic Acid
Pancreatectomy
Hyalin
Phosphopyruvate Hydratase
Abdominal Wall
Vimentin
Fine Needle Biopsy
Pancreatic Neoplasms
Abdomen
Blood Vessels
Cell Biology
Tomography

Keywords

  • Clinical
  • Cytopathological features
  • Imaging
  • Pancreas
  • Solid pseudopapillary tumor

ASJC Scopus subject areas

  • Anatomy

Cite this

Clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas : A clinicopathologic study of three cases and review of the literature. / Bhanot, Punam; Nealon, William H.; Walser, Eric; Bhutani, Manoop S.; Tang, Wendell W.; Logroño, Roberto.

In: Diagnostic Cytopathology, Vol. 33, No. 6, 12.2005, p. 421-428.

Research output: Contribution to journalArticle

Bhanot, Punam ; Nealon, William H. ; Walser, Eric ; Bhutani, Manoop S. ; Tang, Wendell W. ; Logroño, Roberto. / Clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas : A clinicopathologic study of three cases and review of the literature. In: Diagnostic Cytopathology. 2005 ; Vol. 33, No. 6. pp. 421-428.
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