{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:57:15Z","timestamp":1790927835241,"version":"4.1.0"},"reference-count":30,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mucinous cystic neoplasm and intraductal papillary mucinous neoplasm are 2 types of cystic pancreatic mucinous tumors, each with its own distinct clinicopathologic features and pathogenetic mechanisms. We report here an unusual pancreatic mucinous neoplasm with features of both a mucinous cystic neoplasm and an intraductal papillary mucinous neoplasm in a 40-year-old woman who underwent total pancreatectomy. The endoscopic retrograde cholangiopancreatogram and gross examination demonstrated a mucin-producing intraductal neoplasm involving the length of the main pancreatic duct, typical of main duct intraductal papillary mucinous neoplasm, but histology of the main duct showed involvement by a biphasic tumor composed of columnar epithelium overlying ovarian-type stroma, characteristic of a mucinous cystic neoplasm. Immunohistochemistry confirmed that the stromal cells expressed estrogen and progesterone receptors, inhibin, and calretinin. Pancreatic mucinous cystic neoplasm involving the entire main pancreatic duct has not, to our knowledge, been previously reported.<\/jats:p>","DOI":"10.5858\/135.2.264","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T13:00:37Z","timestamp":1613134837000},"page":"264-267","source":"Crossref","is-referenced-by-count":15,"title":["Pancreatic Mucinous Cystic Neoplasm of the Main Pancreatic Duct"],"prefix":"10.5858","volume":"135","author":[{"given":"Ricard","family":"Masia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Mino-Kenudson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L","family":"Warshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha B","family":"Pitman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Misdraji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"suppl 1","key":"i1543-2165-135-2-264-b01","series-title":"Mod Pathol","first-page":"S71","article-title":"Cystic lesions of the pancreas","volume":"20","author":"Adsay\n              VN.","year":"2007","unstructured":"Adsay\n              VN. \n          \n          Cystic lesions of the pancreas. Mod Pathol. 2007;20(suppl 1):S71\u2013S93."},{"issue":"4","key":"i1543-2165-135-2-264-b02","series-title":"Am J Surg Pathol","first-page":"410","article-title":"Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors","volume":"234","author":"Zamboni\n              G,","year":"1999","unstructured":"Zamboni\n              G, \n            \n              Scarpa\n              A, \n            \n              Bogina\n              G. \n            et al. \n          Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. Am J Surg Pathol. 1999;234(4):410\u2013422."},{"issue":"1\u20132","key":"i1543-2165-135-2-264-b03","series-title":"Pancreatology","first-page":"17","article-title":"International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas","volume":"6","author":"Tanaka\n              M,","year":"2006","unstructured":"Tanaka\n              M, \n            \n              Chari\n              S, \n            \n              Adsay\n              V. \n            et al. \n          International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 2006;6(1\u20132):17\u201332."},{"issue":"1","key":"i1543-2165-135-2-264-b04","series-title":"Cancer","first-page":"62","article-title":"Intraductal papillary-mucinous neoplasms of the pancreas","volume":"94","author":"Adsay\n              NV,","year":"2002","unstructured":"Adsay\n              NV, \n            \n              Conlon\n              KC, \n            \n              Zee\n              SY, \n            \n              Brennan\n              MF, \n            \n              Klimstra\n              DS. \n          \n          Intraductal papillary-mucinous neoplasms of the pancreas. Cancer. 2002;94(1):62\u201377."},{"issue":"3","key":"i1543-2165-135-2-264-b05","series-title":"Surgery","first-page":"448","article-title":"Intraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stroma","volume":"140","author":"Murakami\n              Y,","year":"2006","unstructured":"Murakami\n              Y, \n            \n              Uemura\n              K, \n            \n              Ohge\n              H. \n            et al. \n          Intraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stroma. Surgery. 2006;140(3):448\u2013453."},{"issue":"12","key":"i1543-2165-135-2-264-b06","series-title":"Am J Surg Pathol","first-page":"1561","article-title":"Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: its histopathologic difference between 2 major types","volume":"30","author":"Ban\n              S,","year":"2006","unstructured":"Ban\n              S, \n            \n              Naitoh\n              Y, \n            \n              Mino-Kenudson\n              M. \n            et al. \n          Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: its histopathologic difference between 2 major types. Am J Surg Pathol. 2006;30(12):1561\u20131569."},{"issue":"3","key":"i1543-2165-135-2-264-b07","series-title":"J Hepatobiliary Pancreat Surg","first-page":"243","article-title":"Mucin expression profile in pancreatic cancer and the precursor lesions","volume":"14","author":"Nagata\n              K,","year":"2007","unstructured":"Nagata\n              K, \n            \n              Horinouchi\n              M, \n            \n              Saitou\n              M. \n            et al. \n          Mucin expression profile in pancreatic cancer and the precursor lesions. J Hepatobiliary Pancreat Surg. 2007;14(3):243\u2013254."},{"issue":"S1","key":"i1543-2165-135-2-264-b08","series-title":"Lab Invest","first-page":"277A","article-title":"Mucinous cystic neoplasm: unique ovarian stroma but heterogeneous epithelial lining","volume":"68","author":"Mino-Kenudson\n              M,","year":"2006","unstructured":"Mino-Kenudson\n              M, \n            \n              Ban\n              S, \n            \n              Deshpande\n              V. \n            et al. \n          Mucinous cystic neoplasm: unique ovarian stroma but heterogeneous epithelial lining. Lab Invest. 2006;68(S1):277A."},{"issue":"7","key":"i1543-2165-135-2-264-b09","series-title":"Histopathology","first-page":"813","article-title":"Human pancreatic mucinous cystadenoma is characterized by distinct mucin, cytokeratin and CD10 expression compared with intraductal papillary-mucinous adenoma","volume":"48","author":"Handra-Luca\n              A,","year":"2006","unstructured":"Handra-Luca\n              A, \n            \n              Flejou\n              J-F, \n            \n              Rufat\n              P. \n            et al. \n          Human pancreatic mucinous cystadenoma is characterized by distinct mucin, cytokeratin and CD10 expression compared with intraductal papillary-mucinous adenoma. Histopathology. 2006;48(7):813\u2013821."},{"issue":"4","key":"i1543-2165-135-2-264-b10","series-title":"Am J Surg Pathol","first-page":"466","article-title":"The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas","volume":"26","author":"Luttges\n              J,","year":"2002","unstructured":"Luttges\n              J, \n            \n              Feyerabend\n              B, \n            \n              Buchelt\n              T, \n            \n              Pacena\n              M, \n            \n              Kloppel\n              G. \n          \n          The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas. Am J Surg Pathol. 2002;26(4):466\u2013471."},{"issue":"7","key":"i1543-2165-135-2-264-b11","series-title":"Am J Surg Pathol","first-page":"839","article-title":"Pathologically and biologically distinct types of epithelium in intraductal papillary mucinous neoplasms","volume":"28","author":"Adsay\n              NV,","year":"2004","unstructured":"Adsay\n              NV, \n            \n              Merati\n              K, \n            \n              Basturk\n              O. \n            et al. \n          Pathologically and biologically distinct types of epithelium in intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2004;28(7):839\u2013848."},{"issue":"5","key":"i1543-2165-135-2-264-b12","series-title":"Virchows Arch","first-page":"794","article-title":"Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study","volume":"447","author":"Furukawa\n              T,","year":"2005","unstructured":"Furukawa\n              T, \n            \n              Kloppel\n              G, \n            \n              Adsay\n              NV. \n            et al. \n          Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study. Virchows Arch. 2005;447(5):794\u2013799."},{"issue":"5","key":"i1543-2165-135-2-264-b13","series-title":"Virchows Arch","first-page":"437","article-title":"Clonality and K-ras mutation analyses of epithelia in intraductal papillary mucinous tumor and mucinous cystic tumor of the pancreas","volume":"441","author":"Yoshizawa\n              K,","year":"2002","unstructured":"Yoshizawa\n              K, \n            \n              Nagai\n              H, \n            \n              Sakurai\n              S. \n            et al. \n          Clonality and K-ras mutation analyses of epithelia in intraductal papillary mucinous tumor and mucinous cystic tumor of the pancreas. Virchows Arch. 2002;441(5):437\u2013443."},{"issue":"56","key":"i1543-2165-135-2-264-b14","series-title":"Oncogene","first-page":"9042","article-title":"Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays","volume":"23","author":"Fukushima\n              N,","year":"2004","unstructured":"Fukushima\n              N, \n            \n              Sato\n              N, \n            \n              Prasad\n              N. \n            et al. \n          Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays. Oncogene. 2004;23(56):9042\u20139051."},{"issue":"7","key":"i1543-2165-135-2-264-b15","series-title":"Am J Gastroenterol","first-page":"811","article-title":"Mucinous cystadenoma: pitfalls of differential diagnosis","volume":"84","author":"Sachs\n              JR,","year":"1989","unstructured":"Sachs\n              JR, \n            \n              Deren\n              JJ, \n            \n              Sohn\n              M, \n            \n              Nusbaum\n              M. \n          \n          Mucinous cystadenoma: pitfalls of differential diagnosis. Am J Gastroenterol. 1989;84(7):811\u2013816."},{"issue":"suppl 1","key":"i1543-2165-135-2-264-b01","series-title":"Mod Pathol","first-page":"S71","article-title":"Cystic lesions of the pancreas","volume":"20","author":"Adsay\n              VN.","year":"2007","unstructured":"Adsay\n              VN. \n          \n          Cystic lesions of the pancreas. Mod Pathol. 2007;20(suppl 1):S71\u2013S93."},{"issue":"4","key":"i1543-2165-135-2-264-b02","series-title":"Am J Surg Pathol","first-page":"410","article-title":"Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors","volume":"234","author":"Zamboni\n              G,","year":"1999","unstructured":"Zamboni\n              G, \n            \n              Scarpa\n              A, \n            \n              Bogina\n              G. \n            et al. \n          Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. Am J Surg Pathol. 1999;234(4):410\u2013422."},{"issue":"1\u20132","key":"i1543-2165-135-2-264-b03","series-title":"Pancreatology","first-page":"17","article-title":"International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas","volume":"6","author":"Tanaka\n              M,","year":"2006","unstructured":"Tanaka\n              M, \n            \n              Chari\n              S, \n            \n              Adsay\n              V. \n            et al. \n          International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 2006;6(1\u20132):17\u201332."},{"issue":"1","key":"i1543-2165-135-2-264-b04","series-title":"Cancer","first-page":"62","article-title":"Intraductal papillary-mucinous neoplasms of the pancreas","volume":"94","author":"Adsay\n              NV,","year":"2002","unstructured":"Adsay\n              NV, \n            \n              Conlon\n              KC, \n            \n              Zee\n              SY, \n            \n              Brennan\n              MF, \n            \n              Klimstra\n              DS. \n          \n          Intraductal papillary-mucinous neoplasms of the pancreas. Cancer. 2002;94(1):62\u201377."},{"issue":"3","key":"i1543-2165-135-2-264-b05","series-title":"Surgery","first-page":"448","article-title":"Intraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stroma","volume":"140","author":"Murakami\n              Y,","year":"2006","unstructured":"Murakami\n              Y, \n            \n              Uemura\n              K, \n            \n              Ohge\n              H. \n            et al. \n          Intraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stroma. Surgery. 2006;140(3):448\u2013453."},{"issue":"12","key":"i1543-2165-135-2-264-b06","series-title":"Am J Surg Pathol","first-page":"1561","article-title":"Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: its histopathologic difference between 2 major types","volume":"30","author":"Ban\n              S,","year":"2006","unstructured":"Ban\n              S, \n            \n              Naitoh\n              Y, \n            \n              Mino-Kenudson\n              M. \n            et al. \n          Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: its histopathologic difference between 2 major types. Am J Surg Pathol. 2006;30(12):1561\u20131569."},{"issue":"3","key":"i1543-2165-135-2-264-b07","series-title":"J Hepatobiliary Pancreat Surg","first-page":"243","article-title":"Mucin expression profile in pancreatic cancer and the precursor lesions","volume":"14","author":"Nagata\n              K,","year":"2007","unstructured":"Nagata\n              K, \n            \n              Horinouchi\n              M, \n            \n              Saitou\n              M. \n            et al. \n          Mucin expression profile in pancreatic cancer and the precursor lesions. J Hepatobiliary Pancreat Surg. 2007;14(3):243\u2013254."},{"issue":"S1","key":"i1543-2165-135-2-264-b08","series-title":"Lab Invest","first-page":"277A","article-title":"Mucinous cystic neoplasm: unique ovarian stroma but heterogeneous epithelial lining","volume":"68","author":"Mino-Kenudson\n              M,","year":"2006","unstructured":"Mino-Kenudson\n              M, \n            \n              Ban\n              S, \n            \n              Deshpande\n              V. \n            et al. \n          Mucinous cystic neoplasm: unique ovarian stroma but heterogeneous epithelial lining. Lab Invest. 2006;68(S1):277A."},{"issue":"7","key":"i1543-2165-135-2-264-b09","series-title":"Histopathology","first-page":"813","article-title":"Human pancreatic mucinous cystadenoma is characterized by distinct mucin, cytokeratin and CD10 expression compared with intraductal papillary-mucinous adenoma","volume":"48","author":"Handra-Luca\n              A,","year":"2006","unstructured":"Handra-Luca\n              A, \n            \n              Flejou\n              J-F, \n            \n              Rufat\n              P. \n            et al. \n          Human pancreatic mucinous cystadenoma is characterized by distinct mucin, cytokeratin and CD10 expression compared with intraductal papillary-mucinous adenoma. Histopathology. 2006;48(7):813\u2013821."},{"issue":"4","key":"i1543-2165-135-2-264-b10","series-title":"Am J Surg Pathol","first-page":"466","article-title":"The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas","volume":"26","author":"Luttges\n              J,","year":"2002","unstructured":"Luttges\n              J, \n            \n              Feyerabend\n              B, \n            \n              Buchelt\n              T, \n            \n              Pacena\n              M, \n            \n              Kloppel\n              G. \n          \n          The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas. Am J Surg Pathol. 2002;26(4):466\u2013471."},{"issue":"7","key":"i1543-2165-135-2-264-b11","series-title":"Am J Surg Pathol","first-page":"839","article-title":"Pathologically and biologically distinct types of epithelium in intraductal papillary mucinous neoplasms","volume":"28","author":"Adsay\n              NV,","year":"2004","unstructured":"Adsay\n              NV, \n            \n              Merati\n              K, \n            \n              Basturk\n              O. \n            et al. \n          Pathologically and biologically distinct types of epithelium in intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2004;28(7):839\u2013848."},{"issue":"5","key":"i1543-2165-135-2-264-b12","series-title":"Virchows Arch","first-page":"794","article-title":"Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study","volume":"447","author":"Furukawa\n              T,","year":"2005","unstructured":"Furukawa\n              T, \n            \n              Kloppel\n              G, \n            \n              Adsay\n              NV. \n            et al. \n          Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study. Virchows Arch. 2005;447(5):794\u2013799."},{"issue":"5","key":"i1543-2165-135-2-264-b13","series-title":"Virchows Arch","first-page":"437","article-title":"Clonality and K-ras mutation analyses of epithelia in intraductal papillary mucinous tumor and mucinous cystic tumor of the pancreas","volume":"441","author":"Yoshizawa\n              K,","year":"2002","unstructured":"Yoshizawa\n              K, \n            \n              Nagai\n              H, \n            \n              Sakurai\n              S. \n            et al. \n          Clonality and K-ras mutation analyses of epithelia in intraductal papillary mucinous tumor and mucinous cystic tumor of the pancreas. Virchows Arch. 2002;441(5):437\u2013443."},{"issue":"56","key":"i1543-2165-135-2-264-b14","series-title":"Oncogene","first-page":"9042","article-title":"Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays","volume":"23","author":"Fukushima\n              N,","year":"2004","unstructured":"Fukushima\n              N, \n            \n              Sato\n              N, \n            \n              Prasad\n              N. \n            et al. \n          Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays. 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