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Presented by Ralph Hruban, M.D. and prepared by Shien Micchelli, M.D.
Case 5: This middle-aged woman underwent a gastrectomy for a biopsy-proven infiltrating adenocarcinoma of the stomach.
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1. Question
Week 261: Case 5
This middle-aged woman underwent a gastrectomy for a biopsy-proven infiltrating adenocarcinoma of the stomach. The lesion illustrated was found by the pathologist as part of a hunt for lymph nodes in the perigastric fat.images/3_13_06_5a.jpg
images/3_13_06_5b.jpg
images/3_13_06_5c.jpg
images/3_13_06_5d.jpgCorrect
Answer: PanIN in ectopic pancreas
Histology: The lesion is composed of mature acinar cells, ducts and islets of Langerhans. The ducts are remarkable for a papillary epithelial proliferation with moderate architectural and cytologic atypia.
Discussion: Ectopic pancreas is defined as pancreatic tissue found outside its normal anatomic location. Ectopic pancreas is not that uncommon, and there have even been case reports of adenocarcinomas arising in association with gastric heterotopic pancreas (J Surg Oncol. 2004 Jul 15;87(1):53-7). The PanIN lesion illustrated in the ectopic pancreas in this case is presumably the precursor to these carcinomas.
Incorrect
Answer: PanIN in ectopic pancreas
Histology: The lesion is composed of mature acinar cells, ducts and islets of Langerhans. The ducts are remarkable for a papillary epithelial proliferation with moderate architectural and cytologic atypia.
Discussion: Ectopic pancreas is defined as pancreatic tissue found outside its normal anatomic location. Ectopic pancreas is not that uncommon, and there have even been case reports of adenocarcinomas arising in association with gastric heterotopic pancreas (J Surg Oncol. 2004 Jul 15;87(1):53-7). The PanIN lesion illustrated in the ectopic pancreas in this case is presumably the precursor to these carcinomas.
