Diagnosis: Pancreatic adenocarcinom
• The photomicrographs depict pancreatic adenocarcinoma. Figure 1shows a cluster of malignant epithelial cells with nuclei that are enlarged compared to the small cluster of benign epithelial cells in the upper left of the photo.
• Figure 2 displays a “drunken honeycomb” pattern, i.e., disorganization, with nuclear overlapping and variation in nuclear sizes (anisonucleosis).
• Figure 3 shows malignant cells with irregular nuclear contours, prominent nucleoli, and anisonucleosis.
• In Figure 4 there is a single large malignant epithelial cell (note size compared to red blood cells).
• Pancreatic pseudocyst is a complication of acute and chronic pancreatitis. Pseudocysts lack an epithelial lining.
• Patients with pancreatoblastoma and acinar cell carcinoma may have elevated levels of AFP, but patients with pancreatic adenocarcinoma usually do not.
• The 5-year survival rate of patients with pancreatic adenocarcinoma is less than 10%. Solid pseudopapillary tumor (SPPT) of the pancreas characteristically arises in the pancreas in young women. More than 90% of SPT behave in a benign fashion. KRAS mutations are present in 95% of pancreatic adenocarcinomas. Mutation of SMAD4 (DPC4) also is seen.
