Observational analysis revealed high grade intraepithelial neoplasia in a patient with pancreatic cysts, suggesting early detection methods may improve outcomes.
A 71-year-old woman visited our hospital for evaluation of asymptomatic pancreatic cysts. Magnetic resonance cholangiopancreatography (MRCP) revealed dilated branch ducts (retention cysts) surrounding a caliber change of the main pancreatic duct (MPD) in the pancreatic body ([Fig. 1] a). Contrast-enhanced computed tomography (CT) demonstrated localized pancreatic parenchymal atrophy around the MPD irregularity ([Fig. 1] b). Endoscopic ultrasound (EUS) also revealed retention cysts surrounding the MPD caliber change with upstream MPD dilatation ([Fig. 1] c). No obvious tumor was detected on any imaging modalities. Based on these findings, isolated high grade intraepithelial neoplasia (HGIN) of the pancreas without invasive carcinoma was strongly suspected. As there was no visible mass suitable for EUS-guided tissue acquisition, pancreatic juice cytology was selected as the technique for further investigation.
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Azuma et al. (2025) studied this question.
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