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Erschienen in: Die Pathologie 5/2021

16.08.2021 | Pankreaskarzinom | Schwerpunkt: Pankreaspathologie

Intraduktale Pankreasneoplasien

verfasst von: Univ.-Prof. Dr. Irene Esposito, Lena Häberle, Aslihan Yavas, Anne Kraft, Matthias M. Gaida

Erschienen in: Die Pathologie | Ausgabe 5/2021

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Zusammenfassung

Die aktuelle WHO-Klassifikation für gastrointestinale Tumoren (2019) beinhaltet Neuerungen in der Einteilung von intraduktalen Pankreasneoplasien, die auf weiterführenden Erkenntnissen zum genetischen Profil der Tumoren und zum Malignitätspotenzial basieren. Zu dieser Gruppe zählen pankreatische intraepitheliale Neoplasien (PanIN) und intraduktale papillär-muzinöse Neoplasien (IPMN) als Vorläufer des duktalen Adenokarzinoms, wohingegen die intraduktalen onkozytär-papillären Neoplasien (IOPN) und die intraduktalen tubulopapillären Neoplasien (ITPN) mit weniger aggressiven Subtypen von Pankreaskarzinomen und besserer Prognose assoziiert sind. Daher ist es von größter Bedeutung, diese Läsionen korrekt zu klassifizieren und von anderen nichtduktalen Neoplasien zu differenzieren, wie beispielsweise von neuroendokrinen Tumoren und Azinuszellkarzinomen, welche selten auch ein intraduktales Wachstum aufweisen können. PanIN sind mikroskopische Läsionen mit begrenzter klinischer Signifikanz. Hingegen können alle anderen intraduktalen Neoplasien mittels Bildgebung als zystische Prozesse und/oder solide Tumoren identifiziert werden, wodurch die Indikation für eine mögliche chirurgische Resektion gegeben ist. In dieser Übersichtsarbeit werden die diagnostisch relevanten Aspekte intraduktaler Neoplasien des Pankreas vorgestellt. Diese sind für die Diskussion im Rahmen interdisziplinärer Tumorkonferenzen (Resektion versus watch & wait) sowie zur intraoperativen Entscheidung des Resektionsausmaßes von maßgeblicher Bedeutung.
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Metadaten
Titel
Intraduktale Pankreasneoplasien
verfasst von
Univ.-Prof. Dr. Irene Esposito
Lena Häberle
Aslihan Yavas
Anne Kraft
Matthias M. Gaida
Publikationsdatum
16.08.2021
Verlag
Springer Medizin
Erschienen in
Die Pathologie / Ausgabe 5/2021
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI
https://doi.org/10.1007/s00292-021-00966-1

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