Intraductal Tubulopapillary Neoplasm
Mari Mino-Kenudson, MD
Key Facts
Terminology
Solid epithelial neoplasm composed of back-to-back tubular glands and papillae that grows within and obstructs pancreatic ducts
No grossly visible mucin
Clinical Issues
Very rare entity
Majority are discovered incidentally
Microscopic Pathology
Tubulopapillary or tubular growth
Some may resemble pyloric gland adenomas
Scant or absent mucin
Cases with high-grade dysplasia have marked architectural and cytologic atypia, mitoses, necrosis
Invasive component may be similar to intraductal component or highly infiltrative
 This ITPN is forming solid nodules  that obstruct the dilated pancreatic duct. There is no grossly visible mucin. |
 This low-power view shows an ITPN with stromal invasion. Note the solid masses with focal necrosis  within a dilated duct. A focus of invasion is also seen  . |
TERMINOLOGY
Abbreviations
Intraductal tubulopapillary neoplasm (ITPN)
Intraductal tubular carcinoma (ITC)
Intraductal tubular adenoma (ITA)
Intraductal papillary mucinous neoplasm (IPMN)
Definitions
ITPN: Solid epithelial neoplasm composed of back-toback tubular glands and papillae that grows within and obstructs pancreatic ducts
No visible mucin
Some authorities group ITC and ITA together as a separate diagnostic classification known as intraductal tubular neoplasms
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