This was one of the first IPMT cases seen on MRI, and it fueled an enormous amount of research on the disease. Once she was correctly diagnosed, this patient underwent a distal pancreatectomy, which revealed that she not only had IPMT, but carcinoma in situ and a small area of invasive carcinoma. Nevertheless, she was completely cured by the distal pancreatectomy. Figure 17 Figure 17 shows the patient's pathological specimens. For those interested in breast pathology, this is exactly what a papillary carcinoma of the breast looks like.
Neoplastic tissue is heaped up in a papillary morphology.
If IPMT involves the main pancreatic duct, it will often spread into the branch ducts. Unfortunately, the proximal margin of disease also has some dyplasia as well, and this leads into one of the big problems, that this is a multifocal disease.