Pancreatic cancer classification: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 3: Line 3:
{{CMG}}; {{AE}} {{ARK}}
{{CMG}}; {{AE}} {{ARK}}
==Overview==
==Overview==
Pancreatic cancer can be classified into malignant and borderline malignant. Duct cell carcinoma is the most common type of pancreatic cancer.
 


==Classification==
==Classification==
*'''Cellular Classification of Pancreatic Cancer'''<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publiciation/pdq</ref>
:* Pancreatic cancer includes the following carcinomas:
::* '''''Malignant'''''
:::* Duct cell carcinoma (90% of all cases)
:::* [[Acinar cell carcinoma]]
:::* [[Adenosquamous carcinoma]]
:::* [[Cystadenocarcinoma]] (serous and mucinous types)
:::* Giant cell carcinoma
:::* Invasive adenocarcinoma associated with cystic mucinous neoplasm or intraductal papillary mucinous neoplasm
:::* Mixed type (ductal-endocrine or acinar-endocrine)
:::* Mucinous carcinoma
:::* [[Pancreatoblastoma]]
:::* Papillary-cystic neoplasm (Frantz tumor). This tumor has lower malignant potential and may be cured with surgery alone
:::* Papillary mucinous carcinoma
:::* Signet ring carcinoma
:::* [[Small cell carcinoma]]
:::* Unclassified
:::* Undifferentiated carcinoma
::* '''''Borderline Malignancies'''''
:::* Intraductal papillary mucinous tumor with dysplasia
:::* Mucinous cystic tumor with dysplasia
:::* Pseudopapillary solid tumor


<br />
<br />

Revision as of 16:40, 14 November 2017

Pancreatic cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pancreatic Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pancreatic cancer classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pancreatic cancer classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pancreatic cancer classification

CDC on Pancreatic cancer classification

Pancreatic cancer classification in the news

Blogs on Pancreatic cancer classification

Directions to Hospitals Treating Pancreatic cancer

Risk calculators and risk factors for Pancreatic cancer classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Classification


  • Types of Pancreatic Cancers:[1]
Types of Pancreatic Cancers
Pancreatic Exocrine Cancers
  • Adenocarcinoma
  • Acinar cell carcinoma
  • Adenosquamous carcinoma
  • Giant cell tumour
  • Intraductal papillary mucinous neoplasm (IPMN)
  • Mucinous cystadenocarcinoma
  • Pancreatoblastoma
  • Serous cystadenocarcinoma
  • Solid and pseudopapillary tumours
Pancreatic Endocrine Cancers (Pancreatic Neuroendocrine Tumours)
  • Gastrinoma
  • Glucagonoma
  • Insulinoma
  • Nonfunctional islet cell tumour
  • Somatostatinoma
  • Vasoactive intestinal peptide releasing tumour (VIPoma)


  • Types of Pancreatic Intraepithelial Neoplasia (PanIN):[1]
Types of Pancreatic Intraepithelial Neoplasia (PanIN)
PanIN 1 (low grade)
  • Minimal degree of atypia
  • Subclassified into PanIN 1A: absence of micropapillary infoldings of the epithelium; and 1B, presence of micropapillary infoldings of the epithelium
PanIN 2 (intermediate grade)
  • Moderate degree of atypia, including loss of polarity, nuclear crowding, enlarged nuclei, pseudostratification, and hyperchromatism
  • Mitoses are rarely seen
PanIN 3 (high grade/carcinoma in situ)
  • Severe atypia, with varying degrees of cribriforming, luminal necrosis, and atypical mitoses
  • Contained within the basement membrane


  • TNM classification for pancreatic cancer:[1]
TNM Classification for Pancreatic Cancer:
Primary tumor
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1 Tumor limited to the pancreas, ≤2 cm in greatest dimension
T2 Tumor limited to the pancreas, >2 cm in greatest dimension
T3 Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery
T4 Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor)
Regional lymph nodes
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
Distant metastases
M0 No distant metastasis
M1 Distant metastasis


  • Stage grouping of pancreatic cancer:[1]
Stage grouping of pancreatic cancer:
Stage T N M
0 Tis N0 M0
IA T1 N0 M0
IB T2 N0 M0
IIA T3 N0 M0
IIB T1 N1 M0
T2 N1 M0
T3 N1 M0
III T4 Any N M0
IV Any T Any N M1


  • Functional Pancreatic Neuroendocrine Tumors and their Characteristics are mentioned in the following table:[2]
Functional Pancreatic Neuroendocrine Tumors and their Characteristics
Tumor type and syndrome Location in pancreas Signs and symptoms Circulating biomarkers
Insulinoma (Whipple’s triad)
  • Head, body, tail (evenly distributed)
  • Hypoglycemia, dizziness, sweating, tachycardia, tremulousness, confusion, seizure
  • CgA and CgB, insulin inappropriate for blood glucose level, proinsulin, C-peptide
Gastrinoma (Zollinger–Ellison)
  • Gastrinoma triangle Often extrapancreatic (duodenal); can be found anywhere in gland
  • Gastric acid hypersecretion, peptic ulcer, diarrhea, esophagitis, epigastric pain
  • CgA, gastrin, PP (35%)
VIPoma (Verner– Morrison syndrome, WDHA)
  • Distal pancreas (body and tail) Often spread outside pancreas
  • Watery diarrhea, hypokalemia, achlorhydria (or acidosis)
  • CgA, VIP
Glucagonoma
  • Body and tail of pancreas Often large and spread outside pancreas
  • Diabetes (hyperglycemia), necrolytic migratory erythema, stomatitis, glossitis, angular cheilitis
  • CgA, glucagon, glycentin
Somatostatinoma
  • Pancreatoduodenal groove, ampullary, periampullary
  • Gallstones, diabetes (hyperglycemia), steatorrhea
  • CgA, somatostatin
Ppoma
  • Head of pancreas
  • None
  • CgA, PP

Refrences

  1. ↑ 1.0 1.1 1.2 1.3 Bond-Smith G, Banga N, Hammond TM, Imber CJ (2012). "Pancreatic adenocarcinoma". BMJ. 344: e2476. doi:10.1136/bmj.e2476. PMID 22592847.
  2. ↑ Ryan DP, Hong TS, Bardeesy N (2014). "Pancreatic adenocarcinoma". N Engl J Med. 371 (11): 1039–49. doi:10.1056/NEJMra1404198. PMID 25207767.
Retrieved from "https://www.wikidoc.org/index.php?title=Pancreatic_cancer_classification&oldid=1388497"