Coexisting pancreatic serous cystadenoma and pancreatic ductal adenocarcinoma: A cytological-pathologic correlation with literature review
| Autor: | Daniel J. Rowan, Mamta Pant, Catherine Hagen, Tamara Giorgadze |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Pathology medicine.medical_specialty endocrine system diseases medicine.medical_treatment Pancreatic Intraepithelial Neoplasia Pancreatic serous cystadenoma Malignancy Pathology and Forensic Medicine Neoplasms Multiple Primary 03 medical and health sciences 0302 clinical medicine medicine Pancreatic mass Humans Neoadjuvant therapy Aged business.industry Cystadenoma Serous General Medicine Serous Cystadenoma medicine.disease Pancreatic Neoplasms 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Adenocarcinoma business Pancreas Carcinoma Pancreatic Ductal |
| Zdroj: | Annals of Diagnostic Pathology. 42:87-91 |
| ISSN: | 1092-9134 |
| DOI: | 10.1016/j.anndiagpath.2019.07.006 |
| Popis: | Pancreatic serous cystadenoma (SCA) is a benign neoplastic lesion with a distinctive gross and microscopic appearance consisting of numerous thin-walled cysts lined by uniform epithelial cells with clear cytoplasm and small nuclei. The vast majority of serous cystadenomas are benign. Pancreatic SCA has rarely been reported in association with other pancreatic lesions. We present a challenging case in which a cystic and solid pancreatic mass was identified on imaging studies. FNA was performed and showed clusters of atypical cells with significant nuclear pleomorphism (>4:1), disorganized, overlapping nuclei, and prominent nucleoli. The FNA diagnosis was positive for malignancy, consistent with adenocarcinoma. The patient underwent neoadjuvant therapy and pancreaticoduodenectomy. Final pathology showed a serous cystadenoma associated with small foci of high-grade PanIN. The lack of invasive adenocarcinoma in the resection specimen was most likely due to complete response of the tumor to neoadjuvant chemoradiation therapy, but it is also possible that only high-grade PanIN was present initially. To our knowledge, this is the first reported case of SCA and high grade PanIN/PDAC that was assessed by FNA. We discuss the cytologic differential diagnosis and how to avoid potential pitfalls highlighted by this case. |
| Databáze: | OpenAIRE |
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