P17-2 Three Cases of PanIN Found in Dilated Pancreatic Ducts

Pancreatic intraepithelial neoplasia (PanIN) is known as a precancerous lesion of pancreatic cancer, and if it can be resected at the stage of PanIN, it is highly likely to improve the prognosis of pancreatic cancer. A female patient in her 70s was referred to our department because of pancreatic duct dilatation noted on CT scan. Abdominal US and CT showed pancreatic ductal stenosis at the head of the pancreas and dilatation of the pancreatic duct caudally, but no obvious mass was found. Although no definitive diagnosis was obtained, SSPPD was performed. The pathological specimen was diagnosed as PanIN-3. A woman in her 70‘s who was referred to her local physician due to mild elevation of CA19-9. CT and MRCP showed a stenotic lesion of the main pancreatic duct in the pancreatic neck, atrophy of the caudal pancreas and dilatation of the pancreatic duct. Although no definitive diagnosis could be made, a central pancreatectomy was performed after adequate IC. The resection specimen showed papillary changes and nuclear atypia of the pancreatic duct mucosa consistent with the pancreatic ductal stenosis and was diagnosed as PanIN-2. A woman in her 70s. She came to our hospital for a second opinion although she had been followed up for dilatation of the pancreatic tail as indicated by abdominal CT and EUS. She underwent laparoscopic resection of a tumor in the pancreatic tail. The pathological specimen showed papillary changes and mild nuclear atypia in the pancreatic ductal mucosa and was diagnosed as PanIN-2. Pancreatic ductal dilatation on preoperative images is useful for the diagnosis of PanIN, and aggressive resection of PanIN lesions may contribute to improving the prognosis of pancreatic cancer.