obsolete papillary epithelial neoplasm

Obsolete Papillary Epithelial Neoplasms: A Historical Perspective

Papillary epithelial neoplasms, also known as solid and pseudopapillary epithelial neoplasms (SPENs), have been referred to by various names in the past. These obsolete terms include:

• Solid and cystic tumors of the pancreas
• Frantz tumors
• Solid and papillary epithelial neoplasms
• Hamoudi tumors
• Papillary-cystic tumors

These neoplasms were previously considered benign, but their exact nature and origin remained speculative. The original description by Dr. Virginia Kneeland Frantz in 1959 classified the tumor as a benign exocrine glandular lesion, most probably a papillary cystadenoma [11].

Over time, several names have been used to describe these tumors, including solid pseudopapillary neoplasm (SPN) of the pancreas. The World Health Organization (WHO) classified them as a borderline tumor of the exocrine pancreas and named them SPN in 1996 [13]. Today, SPNs are recognized as low-grade malignant tumors composed of poorly cohesive epithelial cells, forming solid and pseudopapillary structures and lacking specific line of pancreatic epithelial differentiation [15].

Key Points:

• Papillary epithelial neoplasms have been referred to by various obsolete names in the past.
• These neoplasms were previously considered benign but their exact nature and origin remained speculative.
• The original description classified the tumor as a benign exocrine glandular lesion, most probably a papillary cystadenoma [11].
• The WHO classified them as a borderline tumor of the exocrine pancreas and named them SPN in 1996 [13].
• Today, SPNs are recognized as low-grade malignant tumors composed of poorly cohesive epithelial cells [15].

References:

[1] Context result 10 [2] Context result 11 [3] Context result 12 [4] Context result 13 [5] Context result 15

Based on the provided context, it appears that there are limited resources available for "obsolete papillary epithelial neoplasm". However, I can provide some information on a related topic.

Papillary Epithelial Neoplasms

While the term "obsolete" is not explicitly mentioned in the search results, I found some information on papillary epithelial neoplasms. These are rare pancreatic tumors that were previously known by various names, including solid and cystic tumors of the pancreas, Frantz tumors, solid and papillary epithelial neoplasms, Hamoudi tumors, and papillary-cystic tumors.

Signs and Symptoms

According to the search results, there are no symptoms unique to solid pseudopapillary neoplasms (a related type of tumor). However, the most common symptom is abdominal pain or discomfort [12]. Some other nonspecific symptoms that may be associated with papillary epithelial neoplasms include:

• Abdominal pain
• Weight loss
• Jaundice
• Steatorrhea (fatty stools)
• Diabetes
• Pancreatitis

Please note that these symptoms are not specific to obsolete papillary epithelial neoplasm and may be associated with other conditions as well.

References

[12] Chung EM, Travis MD. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology. 1996;199:707–711. doi: 10.1148/radiology.199.3.8637992.

Note that I couldn't find any specific information on "obsolete papillary epithelial neoplasm" in the search results, so this answer is based on related information. If you have any further questions or would like me to clarify anything, please let me know!

Diagnostic Modalities for Obsolete Papillary Epithelial Neoplasm

The diagnostic tests for obsolete papillary epithelial neoplasm have evolved over time, and various modalities have been employed to aid in the diagnosis. Here are some of the key diagnostic tests that were used in the past:

• Cytology: Cytological examination was one of the earliest methods used to diagnose papillary epithelial neoplasms (PENs). A study by Crawford et al. in 1998 demonstrated the utility of cytology in diagnosing solid and papillary epithelial neoplasm of the pancreas [15].
• Biopsy: Biopsy was another essential diagnostic tool for PENs. A biopsy sample can provide valuable information about the histological characteristics of the tumor, including the presence of fibrovascular cores covered by epithelium with proliferation [14].
• Imaging studies: Imaging studies such as computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS) were used to assess the size, location, and extent of the tumor. EUS was found to be particularly useful in assessing small lesions undetectable by CT [8].
• Cyst fluid biomarkers: Cyst fluid biomarkers such as CA 19-9 and CEA were also used to aid in the diagnosis of PENs. However, their sensitivity and specificity for diagnosing these tumors are limited.

Key Points

• Cytology was one of the earliest methods used to diagnose papillary epithelial neoplasms.
• Biopsy is essential for providing histological information about the tumor.
• Imaging studies such as EUS were useful in assessing small lesions undetectable by CT.
• Cyst fluid biomarkers have limited sensitivity and specificity for diagnosing PENs.

References

[14] The histological characteristics of papillary neoplasms are fibrovascular cores covered by epithelium with proliferation. In papillomas, a myoepithelial cell layer is present within the fibrovascular cores/at the epithelial-stroma interface. However, the myoepithelial layers may be lost to various extents in atypical to malignant papillary neoplasms.

[8] EUS remained the modality of choice for imaging small lesions undetectable by CT as it has the highest accuracy in assessing the size and extent of the tumor.

[15] Cytological examination was used to diagnose solid and papillary epithelial neoplasm of the pancreas, with a study demonstrating its utility in this context.

Based on the search results, it appears that there are various treatment strategies being investigated for solid pseudopapillary epithelial neoplasms (SPEN), including drug treatments.

According to search result [1], novel treatment strategies such as immunotherapy, redifferentiation therapy, and second-generation kinase inhibitors are under investigation. However, the specific drugs used for treating SPEN are not mentioned in this result.

Search result [3] mentions that a 15-year-old female was treated with cis-platinum and 5-fluorouracil for 6 months, which resulted in regression of the tumor. This suggests that chemotherapy may be an effective treatment option for SPEN.

However, it's worth noting that search result [11] states that the mainstay of treatment is surgical resection, and unlike pancreatic adenocarcinoma, the reported five-year survival rate is as high as 94-97%. This implies that surgery may be the primary treatment approach for SPEN, with drug treatments being used in specific cases or as part of a multidisciplinary treatment plan.

In summary, while there are various treatment strategies being investigated for SPEN, including drug treatments, the most effective and widely accepted treatment approach appears to be surgical resection. However, chemotherapy may also be an option in certain cases.

• Surgical resection is the mainstay of treatment for SPEN [11].
• Chemotherapy, such as cis-platinum and 5-fluorouracil, may be used in specific cases or as part of a multidisciplinary treatment plan [3].
• Novel treatment strategies, including immunotherapy and second-generation kinase inhibitors, are being investigated [1].

References: [1] by S Hamidi · 2023 · Cited by 20 [3] (no author) · 2023 · Cited by 0 [11] (no author) · 1996 · Cited by 0

The differential diagnosis of obsolete papillary epithelial neoplasm involves considering various conditions that may present with similar characteristics. According to the provided context, the following are some of the key points to consider:

• Solid pseudopapillary neoplasm (SPN): This is a rare pancreatic tumor that was previously known as Frantz tumor, Hamoudi's tumor, solid and papillary epithelial neoplasm, or papillary-cystic tumors. SPNs are considered benign, but they can be difficult to distinguish from other pancreatic lesions.
• Pancreatoblastoma: This is a malignant epithelial tumor composed of neoplastic cells showing predominantly acinar differentiation with characteristic squamoid nests. It is one of the differential diagnoses for solid pseudopapillary neoplasm.
• Acinar cell carcinoma: This is another type of pancreatic tumor that can be considered in the differential diagnosis of SPN.
• Pancreatic neuroendocrine tumor (PNET): PNETs are a group of tumors that arise from the pancreas and can be benign or malignant. They may present with similar characteristics to SPNs.

It's worth noting that the classification and terminology for these conditions have evolved over time, and the current understanding is reflected in the 2019 WHO classification of tumors of the pancreas.

In terms of specific diagnostic features, it's mentioned that solid pseudopapillary neoplasm can be distinguished from other pancreatic lesions by its characteristic histological features, including a solid and papillary architecture with fibrovascular cores lined by epithelial cells. However, these features may not always be present or easily identifiable, making differential diagnosis challenging.

References:

• [10] mentions that the differential diagnosis of solid pseudopapillary neoplasm includes pancreatoblastoma, acinar cell carcinoma, and pancreatic neuroendocrine tumor.
• [14] states that solid pseudopapillary neoplasm is classified as a malignant epithelial tumor in the 2019 WHO classification of tumors of the pancreas.
• [13] provides information on the utility of calretinin, inhibin, and WT1 immunohistochemical staining in the differential diagnosis of ovarian tumors, which may be relevant to the discussion of papillary epithelial neoplasms.