Evidence map›Paper›PMID 40601236›Full record

ArticleClinical journal of gastroenterology2025

A case of extensive intraepithelial lesions throughout the pancreas with focal high-grade pancreatic intraepithelial neoplasm: implications for diagnosis and surgical strategy.

Risa Nomura, Juri Ikemoto, Yasutaka Ishii, Yumiko Tatsukawa, Shinya Nakamura, Sayaka Miyamoto, Kenichiro Uemura, Shinya Takahashi, Koji Arihiro, Shiro Oka

Abstract readCase Reports
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In one paragraph

Article in Clinical journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Risa NomuraDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Juri IkemotoDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. juri1118@hiroshima-u.ac.jp.ORCID http://orcid.org/0000-0003-3992-0472
Yasutaka IshiiDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Yumiko TatsukawaDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Shinya NakamuraDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Sayaka MiyamotoDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Kenichiro UemuraDepartment of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Shinya TakahashiDepartment of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Koji ArihiroDepartment of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan.
Shiro OkaDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In the preoperative pathological diagnosis of high-grade pancreatic intraepithelial neoplasia (PanIN), pancreatic juice cytology is commonly used. However, when multiple stenoses are present in the main pancreatic duct (MPD), localizing the tumor can be challenging. Here, we report a case of high-grade PanIN with beaded MPD stenoses and extensive intraepithelial lesions. A 72-year-old man was found to have elevated pancreatic enzymes and cystic MPD dilation on abdominal ultrasonography. Contrast-enhanced computed tomography showed diffuse MPD dilation and localized pancreatic atrophy in the pancreatic head. Magnetic resonance cholangiopancreatography revealed cystic dilation of the MPD in the pancreatic body. Endoscopic ultrasonography showed mild MPD stenosis in the pancreatic head, surrounded by hypoechoic area. Endoscopic retrograde cholangiopancreatography revealed multiple bead-like MPD stenoses in the body of the MPD, and a short stenosis in the pancreatic head. Brush cytology of the MPD stenosis in the pancreatic head revealed malignancy, while lavage cytology from the tail side was suspicious for malignancy. Based on these findings, high-grade PanIN extending from the head to the tail was diagnosed, leading to total pancreatectomy. Histological examination demonstrated extensive intraepithelial neoplastic lesions, with high-grade PanIN corresponding to the MPD stenosis in the pancreatic head.

Indexed as

Carcinoma in SituPancreatic NeoplasmsAgedCholangiopancreatography, Endoscopic RetrogradeHumansMalePancreatic DuctsTomography, X-Ray ComputedHigh-grade pancreatic intraepithelial neoplasiaPancreatic juice cytologyTotal pancreatectomy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.