Evolution of incidental branch-duct intraductal papillary mucinous neoplasms of the pancreas: A study with magnetic resonance imaging cholangiopancreatography

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.