Branch-duct Intraductal Papillary Mucinous Neoplasm with Rapidly Developing Intracystic Xanthogranulomatous Nodules

Intern Med. 2023 Dec 1;62(23):3489-3494. doi: 10.2169/internalmedicine.0862-22. Epub 2023 Apr 14.

Abstract

We herein report a case of a branch-duct intraductal papillary mucinous neoplasm (IPMN) with rapidly developing intracystic xanthogranulomatous nodules. A unilocular cystic lesion without a mural nodule was found in the pancreatic tail of a 69-year-old man. Ten months later, multiple mural nodules emerged unexpectedly within the cyst, and the patient underwent distal pancreatectomy. Based on immunohistochemical studies and a molecular analysis, we diagnosed him with branch-duct IPMN of the gastric immunophenotype. Fragility of the pancreatic duct mucosa and consequent exposure of the wall to pancreatic juice might have caused marked granulation nodule formation in the cyst lumen.

Keywords: droplet digital PCR; intraductal papillary mucinous neoplasm; pancreas; xanthogranulomatous nodule; xanthogranulomatous pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Pancreatic Ductal* / complications
  • Carcinoma, Pancreatic Ductal* / pathology
  • Carcinoma, Pancreatic Ductal* / surgery
  • Cysts*
  • Humans
  • Male
  • Pancreatic Ducts / pathology
  • Pancreatic Intraductal Neoplasms* / pathology
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / diagnosis
  • Pancreatic Neoplasms* / surgery