PAPILLARY-CYSTIC NEOPLASMS OF THE PANCREA S - A CLINICOPATHOLOGICAL, CYTOPATHOLOGIC, IMMUNOHISTOCHEMICAL AND DNA-PLOIDY ANALYSIS

Seven cases of PCNP were studied; 5 females and 2 males, ages ranging from 21 to 68 years (mean 39). All had asymptomatic masses located in the head (3), body (2), isthmus (1) and tail (1). In 4 of them fine-ne edle aspiration (FNA) was done and showed a diagnostic pattern with pa pillary clusters as well as isolated epithelial cells with monomorphic appearance, round nuclei and inconspicuous nucleoli; 5 cases had a su rgical resection and only 2 a biopsy due to unresectable tumors. Histo logically, they showed the typical features of PCNP with solid, papill ary, trabecular and cystic patterns. IHQ studies showed positivity for cytokeratin (n = 5), alfa-1-antitripsina (n = 4), monoclonal NSE (n = 3), chromogranin (n = 3) and estrogen receptors (n = 1). All cases we re negative for insulin, glucagon, somatostatin, EMA and CEA.DNA analy sis done with an image analyzer showed 4 diploid tumors, 2 diploid-tet raploid an 1 aneuploid tumor. One patient died because of postoperativ e complications and the remaining 6 are alive with a mean follow-up of 17 months (236). We emphasize the diagnostic appearance of the tumor on FNA, and the low grade malignant potential of this neoplasm support ed by the predominance of diploid tumors. Our IHQ findings suggest bot h an exocrine and endocrine differentiation.