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Pancreas
WHO classification of Tumors
General

Author: Wei Chen, M.D., Ph.D.

Editorial Board Member review: Andrey Bychkov, M.D., Ph.D. and Raul S. Gonzalez, M.D.

Revised: 9 January 2018, last major update August 2017

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

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Table of Contents
Definition / general | WHO 2010 Classification | Additional references
Cite this page: Chen, W. WHO classification of tumors. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pancreaswho.html. Accessed October 18th, 2018.
Definition / general
  • WHO classification of tumors of the pancreas
  • Currently on 4th edition, published in 2010
  • Based on histologic appearance, not molecular characteristics
  • Similar classification used in College of American Pathologists protocol for examination of pancreas specimens
WHO 2010 Classification
    Epithelial tumors

    BenignICD 0 codes
    • 8551/0 Acinar cell cystadenoma
    • 8441/0 Serous cystadenoma

    Premalignant lesions*ICD 0 codes
    • 8148/2 Pancreatic intraepithelial neoplasia, grade 3 (PanIN-3)
    • 8453/0 Intraductal papillary mucinous neoplasm (IPMN) with low or intermediate grade dysplasia
    • 8453/2 Intraductal papillary mucinous neoplasm (IPMN) with high grade dysplasia
    • 8503/2 Intraductal tubulopapillary neoplasm (ITPN)
    • 8470/0 Mucinous cystic neoplasm (MCN) with low or intermediate grade dysplasia
    • 8470/2 Mucinous cystic neoplasm (MCN) with high grade dysplasia

    Malignant lesionsICD 0 codes
    • 8500/3 Ductal adenocarcinoma
      • 8560/3 Adenosquamous carcinoma
      • 8480/3 Mucinous adenocarcinoma
      • 8576/3 Hepatoid carcinoma
      • 8510/3 Medullary carcinoma
      • 8490/3 Signet ring cell carcinoma
      • 8020/3 Undifferentiated carcinoma
      • 8035/3 Undifferentiated carcinoma with osteoclast-like cells
    • 8550/3 Acinar cell carcinoma
    • 8551/3 Acinar cell cystadenocarcinoma
    • 8453/3 Intraductal papillary mucinous neoplasm (IPMN) with an associated invasive carcinoma
    • 8552/3 Mixed acinar ductal carcinoma
    • 8154/3 Mixed acinar neuroendocrine carcinoma
    • 8154/3 Mixed acinar neuroendocrine ductal carcinoma
    • 8154/3 Mixed ductal neuroendocrine carcinoma
    • 8470/3 Mucinous cystic neoplasm (MCN) with an associated invasive carcinoma
    • 8971/3 Pancreatoblastoma
    • 8441/3 Serous cystadenocarcinoma
    • 8452/3 Solid pseudopapillary neoplasm

    Neoplasms of the neuroendocrine pancreas ICD 0 codes
    Updated to the 2017 classification:
    Lloyd: WHO Classification of Tumours of Endocrine Organs (IARC WHO Classification of Tumours), Fourth Edition, 2017
    • Nonfunctioning (nonsyndromic) neuroendocrine tumors
      • 8150/0 Pancreatic neuroendocrine microadenoma
      • 8150/3 Nonfunctioning pancreatic neuroendocrine tumor
    • 8151/3 Insulinoma
    • 8152/3 Glucagonoma
    • 8156/3 Somatostatinoma
    • 8153/3 Gastrinoma
    • 8155/3 VIPoma
    • Serotonin producing tumors with and without carcinoid syndrome
      • 8241/3 Serotonin producing tumour
    • ACTH producing tumor with Cushing syndrome
      • 8158/3ACTH producing tumour with Cushing syndrome
    • Pancreatic neuroendocrine carcinoma (poorly differentiated neuroendocrine neoplasm)
      • 8246/3 Neuroendocrine carcinoma (poorly differentiated neuroendocrine neoplasm)
      • 8041/3 Small cell neuroendocrine carcinoma
      • 8013/3 Large cell neuroendocrine carcinoma
    • 8154/3 Mixed neuroendocrine nonneuroendocrine neoplasms
      • 8154/3 Mixed ductal neuroendocrine carcinoma
      • 8154/3 Mixed acinar neuroendocrine carcinoma
  • ICD 0 note: the first four digits indicate the specific histological term; the fifth digit after the slash (/) is the behavior code, including /0 for benign tumors, /1 for unspecified, borderline or uncertain behavior, /2 for carcinoma in situ and grade III intraepithelial neoplasia (not used for adrenal tumors), and /3 for malignant tumors

    Mature teratoma

      Mesenchymal tumorsICD 0 codes
    • 9170/0 Lymphangioma
    • 8850/0 Lipoma
    • 8815/1 Solitary fibrous tumor
    • Perivascular epithelioid cell neoplasm (PEComa)
    • 9260/3 Ewing sarcoma
    • 8806/3 Desmoplastic small round cell tumor

      LymphomasICD 0 codes
    • 9680/3 Diffuse large B cell lymphoma (DLBCL)
    • 9690/3 Follicular lymphoma
    • 9699/3Lymphoma of mucosa associated lymphoid tissue (MALT lymphoma)
    • T cell lymphomas

    Secondary tumors

    Note: * According to the Baltimore Consensus Meeting (2015), a two tiered system (low vs. high grade) is proposed for all pancreatic precursor lesions, with the provision that the current intermediate grade dysplasia now be categorized as low grade. High grade dysplasia is to be reserved for only the upper most end of the spectrum ("carcinoma in situ" type lesions).
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