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case_images: a Magnetic resonance pancreatography shows stenosis of the main pancreatic duct (arrowhead) at the pancreatic body and dilatation of the distal side of the main pancreatic duct. A multilocular cystic lesion seems to communicate with the main pancreatic duct (arrow). b Endoscopic retrograde pancreatography shows stenosis of the main pancreatic duct (arrow) at the pancreatic body. c Endoscopic ultrasonography shows a 15-mm multilocular cystic lesion (arrow) with septal structures at the pancreatic body, whereas an intramural nodule or mass shadow was not found.
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case_images: Magnetic resonance pancreatography (MRP) showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct (Fig. 1a).
case_images: Microscopic findings. a, b A cystic lesion lined with a non-atypical cuboidal or flat epithelium with clear cytoplasm is seen; this lesion was diagnosed as a serous cystic neoplasm (a: low-power view, b: high-power view). c, d High-grade pancreatic intraepithelial neoplasia lesions with stromal fibrosis are observed at the main pancreatic duct (c: low-power view, d: high-power view).
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case_images: These lesions were diagnosed as high-grade PanIN (PanIN-2 or -3) (Fig. 2).
case_images: Immunohistochemical findings using anti-VHL antibody. Positive anti-VHL antibody staining is observed at the epithelium of the serous cystic neoplasm (a), whereas negative staining is seen at the epithelium of the pancreatic intraepithelial neoplasia (b). VHL, von Hippel-Lindau.
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case_images: Cruz Biotechnology, Santa Cruz, CA, USA), whereas the epithelium of the PanIN was negative for it (Fig. 3). Communication between the SCN and the main pancreatic ducts was not identified in the resected specimen.