Solid Variant of Serous Cystadenoma of the Pancreas, Cytology Findings
| Autor: | Behdokht Nowroozizadeh, Jessica Peak VanLeer, Wamda Goreal |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Endoscopic ultrasound
Pathology medicine.medical_specialty medicine.diagnostic_test business.industry General Medicine Neuroendocrine tumors medicine.disease Serous Cystadenoma medicine.anatomical_structure Cytology Keratin 7 medicine Adenocarcinoma Clear Cell Differential diagnosis business Pancreas |
| Zdroj: | American Journal of Clinical Pathology. 152:S96-S96 |
| ISSN: | 1943-7722 0002-9173 |
| DOI: | 10.1093/ajcp/aqz118.010 |
| Popis: | Introduction Serous cystadenoma of the pancreas is the most common benign neoplasm of the pancreas, tending to have a very good prognosis and treatable by surgical excision. The solid variant of serous cystadenoma of the pancreas is a very rare subtype with only a few cases reported in recent literature, mostly in elderly females. Case History An asymptomatic 85-year-old woman presented with a large pancreatic mass. Endoscopic ultrasound findings were consistent with an ill-defined large isoechoic mass involving almost the entire pancreas, with no significant common bile duct dilation. Fine-needle aspiration was performed. Results The smears showed groups of cells with uniform nuclei, ample cytoplasm, inconspicuous nucleoli, minimal cytologic atypia, and absent mitotic activity, suggesting a benign or low-grade lesion. A solid aggregate of these cells was present in the cell block, which was positive for CK7, inhibin, and PAS. Negative staining for chromogranin, synaptophysin, and B-catenin helped exclude neuroendocrine tumors and solid pseudopapillary neoplasm. Additionally, absent staining for PAX-8, ER, PR, BRST-2, GATA-3, CK20, CDX2, Melan-A, and calretinin helped exclude other metastatic clear cell lesions. Conclusion Diagnosis of solid variant serous cystadenoma of the pancreas can be challenging due to nonspecific clinical symptoms and misdiagnosis as other solid pancreatic tumors. Based on the clinical, radiologic, cytologic, and immunohistochemical features, we favor a diagnosis of solid variant of serous cystadenoma. Recognition of this lesion is important because the vast majority of solid tumors in the pancreas are malignant. The differential diagnosis includes the rare primary clear-cell “sugar” tumor of the pancreas, clear cell carcinoma, clear cell islet cell tumor, and metastatic renal cell carcinoma. Therefore, the diagnosis of solid-type serous cystadenoma of the pancreas is frequently dependent on a series of immunohistochemical and molecular studies. |
| Databáze: | OpenAIRE |
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