A Case Report of Pancreatic Mucin-producing Cystic Tumor with Carcinoma in Situ of the Dilated Main Pancreatic Duct

Masaru Takahashi, Ritsuro Usui, Shinkichi Watanabe, Hidenobu Miyakawa, Tsuyohiko Honda¹⁾, Masahide Abe²⁾, Touru Furukawa³⁾

Division of Surgery¹⁾ and Internal Medicine²⁾, Tohoku Kosei-Nenkin Hospital
Department of Pathology, The research Institute for Tuberculosis and Cancer, Tohoku University³⁾

We report a case of a pancreatic mucin-producing cystic tumor with carcinoma in situ of the dilated main pancreatic duct detected by immunohistological staining. The patient, a 76-year-old man, was admitted for enlargement of pancreatic cysts and elevation of CEA and CA19-9, although small cysts of the tail of the pancreas were found 5 years earlier. Distal pancreatectomy was performed because of a strong suspicion of malignancy. Macroscopically, multiple cysts were located in the whole pancreas and communicated with the main pancreatic duct. By histological examination of the whole specimen cut into 1.5 mm sections, the only lesion of dilated main pancreatic duct was diagnosed as carcinoma in situ because of swelling of the nuclei, increase in chromatin, distinct nucleoli and disappearance of cell polarity. The lesion was strongly stained immunohistologically in the apical portion and cytoplasm of cells by CEA.

Key words
pancreatic mucin-producing cystic tumor, carcinoma in situ, immunohistological CEA staining

Reprint requests
Masaru Takahashi Division of Surgery, Tohoku Kosei-Nenkin Hospital
10 Takasago, Fukudamachi, Miyaginoku, Sendai, 983 JAPAN

Accepted
November 11, 1992

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