Intraductal Tubular Adenoma of the Pancreas

Definition

Cytologically bland nodular pancreatic intraductal epithelial proliferation with a predominantly tubular architecture

Nodular intraductal growth
- Duct dilated locally
  - May fill and obliterate duct lining
  - Grossly present mucin but no distension of ducts
- Upstream pancreas may be atrophic
Tubular growth pattern predominates
- Tightly packed tubules
- Variable sized tubules
- May be focally villous
Cuboidal to columnar cells resembling normal pyloric gland cells
- Moderate to abundant apical cytoplasm
  - Eosinophilic to clear cytoplasm
  - Abundant cytoplasmic mucin in most cases
- Basal nuclei
- Scattered goblet cells and endocrine cells may be present
Cytologically bland to low grade dysplasia
- Mitotic rate 1-5/50 hpf
Some of the reported cases presented with a synchronous IPMN
No reported association with invasive carcinoma
- Intraductal tubular carcinoma does not appear to be related to intraductal tubular adenoma

Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342