{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T07:44:50Z","timestamp":1768808690700,"version":"3.49.0"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["cytojournal.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\"><jats:title>Objectives:<\/jats:title><jats:p>The Sendai guidelines for management of patients with clinically suspected intraductal papillary mucinous neoplasms (IPMN) recommend resection of cysts &gt; 30 mm, a dilated main pancreatic duct (MPD) &gt; 6 mm, a mural nodule (MN), symptoms or positive cytology. Although sensitive, asymptomatic cysts, nonspecific symptoms, and a high threshold for positive cytology limit the specificity of the guidelines. We have assessed the value of cytology relative to symptom for predicting malignancy in IPMNs without high-risk imaging features.<\/jats:p><\/jats:sec><jats:sec id=\"st2\"><jats:title>Materials and Methods:<\/jats:title><jats:p>We retrospectively reviewed the clinical, radiological, and cytological data of 31 small branch-duct IPMNs without a MN. The cytological presence of high-grade atypical epithelial cells (HGA) was considered true positive, with a corresponding histology of high-grade dysplasia or invasive carcinoma. The performance of cytology versus symptoms was evaluated by calculating the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy.<\/jats:p><\/jats:sec><jats:sec id=\"st3\"><jats:title>Results:<\/jats:title><jats:p>The sensitivity (0.80), specificity (0.85), and accuracy (0.84) of HGA were higher than the corresponding performance characteristics of symptoms (0.60, 0.45, and 0.48, respectively). The NPV of no HGA on cytology was &gt; 95%.<\/jats:p><\/jats:sec><jats:sec id=\"st4\"><jats:title>Conclusions:<\/jats:title><jats:p>Cytology is a better predictor of malignancy than symptoms, for the conservative management of small branch-duct IPMNs. Cytology contributes to a highly accurate triple negative test for malignancy in small IPMN: No dilated MPD, MN or HGA.<\/jats:p><\/jats:sec>","DOI":"10.4103\/1742-6413.90084","type":"journal-article","created":{"date-parts":[[2011,11,21]],"date-time":"2011-11-21T11:43:42Z","timestamp":1321875822000},"page":"21","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Cytological analysis of small branch-duct intraductal papillary mucinous neoplasms provides a more accurate risk assessment of malignancy than symptoms"],"prefix":"10.25259","volume":"8","author":[{"given":"Jill","family":"Ono","sequence":"first","affiliation":[{"name":"Department of Pathology, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt A.","family":"Yaeger","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muriel","family":"Genevay","sequence":"additional","affiliation":[{"name":"Service of Clinical Pathology, University Hospitals of Geneva, Geneva, Swaziland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari","family":"Mino-Kenudson","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William R.","family":"Brugge","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha B.","family":"Pitman","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2011,11,21]]},"reference":[{"key":"10.4103\/1742-6413.90084\/ref-1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1159\/000090023","article-title":"International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas","volume":"6","author":"Tanaka","year":"2006","journal-title":"Pancreatology"},{"key":"10.4103\/1742-6413.90084\/ref-2","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1001\/archsurg.2009.36","article-title":"Current trends in pancreatic cystic neoplasms","volume":"144","author":"Ferrone","year":"2009","journal-title":"Arch 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