MEETING No. 36, NOVEMBER 14th, MONZA HOSPITAL

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7
Case 8
Case 9

Case 6

"PANCREATIC NEOPLASIA"
E. LEONE - San Raffaele Hospital
(pictures by Dr. Leone)

Clinical history: a 69y.o. man is admitted to hospital for obstructive jaundice. GICA is more than 1000 and the endoscopy examination shows a duodenal-ampulla mass. A biopsy is performed and shows an epithelial tumor; a gastric-pancreatoduodenectomy is performed.
Macroscopical description: there is a 3.8cm ampullar mass, which extends both towards the duodenum and the pancreas.
Microscopical description: sections show solid nests, cords and, often, glands with cribriform pattern (pict. 1 - pict. 2 - pict. 3) of monomorphic cells, with preserved nucleus/cytoplasmic ratio, finely granular chromatin, small nucleoli and light, eosinophilic cytoplasm (pict. 4).
The glands contain mucus (pict. 5 - pict. 6) and there are also some psammoma bodies (pict. 7).
There are peri-pancreatic lymph nodes metastases (pict. 8).
With immunohistochemical staining the neoplastic cells are strongly positive for Chromogranin A (pict. 9), Synaptophysin (pict. 10) and Somatostatin (pict. 11) and focally positive for CA19.9 (pict. 12).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10
pict. 11	pict. 12

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