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. 2016 Nov 21;22(43):9562–9570. doi: 10.3748/wjg.v22.i43.9562

Table 3.

Overall view of alert findings occurrence in branch-duct intraductal papillary mucinous neoplasms cysts

Patient/sex/age on baseline MRCP Type and timing of alert finding occurrence Type and timing of associated imaging evolution Final diagnosis Standard of reference Notes
1/female/58 yr Non-enhancing small filling defect at 48 mo in an 8 mm cyst, increased from previous control The same cyst showed initial increase in size (from 5 mm to 8 mm) at 12 mo, followed by decrease (from 8 mm to 5 mm) at 18 mo Mucin plug; no dysplasia or invasive cancer EUS with FNA: mucin plug, negative cytology -
2/male/59 yr Thickened/nodular septa at 15 mo Minimal increase of two cysts at 6 mo No dysplasia or invasive cancer EUS: negative examination No further evolution over the whole follow-up (24 mo). Patient died for alcoholic liver cirrhosis
3/female/68 yr Non-enhancing filling defect at 43 mo Disappearance of a 9 mm cyst at 33 mo Mucin plug; no dysplasia or invasive cancer EUS with FNA: negative cytology -
4/female/55 yr Thickened/nodular septa at 63 and then 71 mo Increase in size of the same cyst from 10 mm to 15 mm at 9 mo Low-grade dysplasia bd-IPMN EUS with FNA: low grade dysplasia bd-IPMN, negative CEA and CA 19.9 Non further evolution over the whole follow-up (99 mo)
5/female/60 yr Dilation of the main pancreatic duct (head, caliber 9 mm) and mural filling defects in the larger cyst (15 mm) at 25 mo No other evolution observed Evolution from bd-IPMN to mixed-type IPMN EUS with FNA (repeated 3 times): negative cytology, elevated CEA, CA 19.9 and amylase. No vascularization of filling defects on Color Doppler exam Liver-transplanted patient (alcoholic cirrhosis) in whom pancreatic surgery was unfeasible. No further evolution over the whole follow up period (92 mo)
6/female/72 yr Increase in size of one cyst from 20 mm to 30 mm at 13 mo Increase in size of the same cyst from 16 mm to 20 mm at 9 mo No dysplasia or invasive cancer Histological examination after surgical resection of the cyst Occurrence of the alert finding preceded by negative EUS
No further evolution over the subsequent follow-up (39 mo)

bd-IPMN: Branch-duct intraductal papillary mucinous neoplasms.