Pathological Differential Diagnosis of Solid-pseudopapillary Neoplasm and Endocrine Tumors of the Pancreas

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2010 Feb 25

PMID 20180245

Citations 24

Authors

Bao-An Liu

Zhuo-Ming Li

Zhan-San Su

Xiao-Ling She

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate differential points of solid-pseudopapillary neoplasm (SPN) of the pancreas and pancreatic endocrine tumor (PET).

Methods: Ten cases of SPN and fourteen cases of PET were studied in this retrospective study. Clinical and pathologic features, immunostaining reactions and beta-catenin gene mutations were analyzed.

Results: The mean age of SPN patients was 25.6 years and these patients had no specific symptoms. The mean diameter of the tumors was 11.0 cm, 9/10 cases were cystic or a mixture of solid and cystic structures, and there was hemorrhage and necrosis on the cut surface in 8/10 (80%) cases. Characteristic pseudopapillary structure and discohesive appearance of the neoplastic cells were observed in all 10 (100%) cases. The results of immunostaining showed that nuclear expression of beta-catenin and loss of E-cadherin in all the cases, was only seen in SPN. Molecular studies discovered that 9/10 (90%) cases harbored a point mutation of exon 3 in beta-catenin gene. On the other hand, the mean age of PET patients was 43.1 years. Eight of 14 cases presented with symptoms caused by hypoglycemia, and the other 6 cases presented with symptoms similar to those of SPN. The mean size of the tumors was 2.9 cm, most of the tumors were solid, only 3/14 (21%) were a mixture of solid and cystic structures, and macroscopic hemorrhage and necrosis were much less common (3/14, 21%). Histologically, tumor cells were arranged in trabecular, acinar or solid patterns and demonstrated no pseudopapillary structure and discohesive appearance in all 14 (100%) cases. The results of immunostaining and mutation detection were completely different with SPN that membrane and cytoplastic expression of beta-catenin without loss of E-cadherin, as well as no mutation in beta-catenin gene in all the cases.

Conclusion: Both macroscopic and microscopic features of SPN are quite characteristic. It is not difficult to distinguish it from PET. If necessary, immunostaining of beta-catenin and E-cadherin is quite helpful to make the differential diagnosis.

Citing Articles

Unraveling the enigma: A comprehensive review of solid pseudopapillary tumor of the pancreas.

Xu Y, Fu D, Yang F World J Gastrointest Oncol. 2024; 16(3):614-629.

PMID: 38577449 PMC: 10989376. DOI: 10.4251/wjgo.v16.i3.614.

Solid Pseudopapillary Neoplasm of the Pancreas: A Clinicopathological Study of 12 Cases With Emphasis on Diagnostic Pitfalls.

Meliti A, Al-Maghrabi J Cureus. 2024; 15(12):e49858.

PMID: 38169685 PMC: 10758586. DOI: 10.7759/cureus.49858.

Frantz's Tumor in Focus: The Tale of a 34-Year-Old Yemeni Female Patient.

Ba-Shammakh S, Alrayes B, Awaisheh U, Hamad H, Al-Qannas M, Abu-Obead H Cureus. 2023; 15(9):e45258.

PMID: 37842463 PMC: 10576631. DOI: 10.7759/cureus.45258.

Reporting a Case of Solid Pseudopapillary Neoplasm of the Pancreas in a 44-Year-Old Woman with Parallel Analysis of Literature.

Singh S, Zhao Q, Sachs T, Hartshorn K Case Rep Oncol Med. 2023; 2023:1768926.

PMID: 37153719 PMC: 10162882. DOI: 10.1155/2023/1768926.

Role of contrast-enhanced ultrasound with time-intensity curve analysis for differentiating hypovascular solid pancreatic lesions.

Wang L, Nie F, Dong T, Li M, Li Y, Yin C Eur Radiol. 2023; 33(7):4885-4894.

PMID: 36725721 DOI: 10.1007/s00330-023-09393-7.

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