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. 2014 Jun 11;233(3):217–227. doi: 10.1002/path.4344

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© 2014 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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P16 and Smad4 immunoexpression in IPMN. Representative images of p16 (A–D) and Smad4 (E–H) immunoreactions are shown. (A) In normal pancreatic parenchyma, p16 is expressed in Langerhans’ islets and in random acinar and duct cells. (B) A barcode-like p16 positivity in a gastric-type IPMN. (C) Strong nuclear and cytoplasmic p16 expression in an oncocytic-type IPMN. (D) p16 expression heterogeneity in a case of pancreatobiliary-type IPMN (positive and negative p16 components are evident). (E) Normal pancreas shows a strong Smad4 expression in all epithelial and stromal cell types, with stronger positivity in Langerhans’ islets. Strong Smad4 expression in intestinal-type (F) and oncocytic-type (G) IPMNs. (H) A Smad4 negative invasive carcinoma infiltrating the stroma surrounding a pancreatobiliary-type IPMN. Original magnifications = ×10 and ×20.