Immunohistochemical staining as supportive diagnostic tool for pseudomyxoma peritonei arising from intraductal papillary mucinous neoplasm: A report of two cases and literature review

Pancreatology. 2020 Sep;20(6):1226-1233. doi: 10.1016/j.pan.2020.06.008. Epub 2020 Jul 7.


Background/objectives: Pseudomyxoma peritonei (PMP) arising from an intraductal papillary mucinous neoplasm of the pancreas (IPMN) is a rare condition. The diagnosis of IPMN as the origin of PMP is mainly inferred from the clinical course and the exclusion of PMP from other organs. The pathological diagnosis has not yet been established. To evaluate the usefulness of immunohistochemical staining for the diagnosis of the primary lesion of PMP as IPMN.

Methods: There are 2 cases of PMP arising from IPMN between March 2010 and December 2019 at National Center for Global Health and Medicine. A PubMed search that reported PMP arising from IPMN identified 16 additional cases. Diagnostic methods and clinicopathological features of 18 cases were compared.

Results: Four cases including our two cases used immunohistochemical staining for the diagnosis of PMP arising from IPMN. The correspondence of the immunohistochemical staining between PMP and IPMN was shown in the three cases including previously reported two cases and one of our two cases to identify the primary lesion of PMP as IPMN. In addition, we revealed that the comparison of the immunostaining pattern of PMP with the representative immunostaining pattern of the candidate primary lesions is helpful for the diagnosis of the primary lesion of PMP.

Conclusions: Immunohistochemical staining is helpful to identify the primary lesion of PMP as IPMN.

Keywords: Immunohistochemical staining; Intraductal papillary mucinous neoplasm (IPMN); Mucinous neoplasm; Pseudomyxoma peritonei (PMP).

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Aged
  • Fatal Outcome
  • Female
  • Humans
  • Immunohistochemistry / methods*
  • Male
  • Middle Aged
  • Pancreatectomy
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Papilloma, Intraductal / diagnosis
  • Papilloma, Intraductal / pathology*
  • Papilloma, Intraductal / surgery
  • Predictive Value of Tests
  • Pseudomyxoma Peritonei / diagnosis
  • Pseudomyxoma Peritonei / pathology*
  • Pseudomyxoma Peritonei / surgery
  • Splenectomy
  • Tomography, X-Ray Computed
  • Treatment Outcome