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Presented by Ralph Hruban, M.D. and prepared by Shien Micchelli, M.D.
Case 3: This elderly cigarette smoker developed painless jaundice.
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Question 1 of 1
1. Question
Week 288: Case 3
This elderly cigarette smoker developed painless jaundice. Imaging revealed an ill-defined mass in the head of the pancreas. A Whipple procedure was preformed.images/10_30_06_3a.jpg
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images/10_30_06_3e.jpgCorrect
Answer: Adenosquamous carcinoma
Histology: This invasive carcinoma has both glandular and squamous differentiation.
Discussion: Adenosquamous carcinoma of the pancreas is a highly aggressive malignant neoplasm with both glandular and squamous differentiation. The glandular differentiation can be highlighted with special stains for mucin. The cells of the squamous component have “hard” eosinophilic cytoplasm and prominent cell-cell junctions. In some instances keratin pearls can be seen. Adenosquamous carcinomas of the pancreas are highly aggressive neoplasms with a mean survival of only 6 months. Pure squamous carcinomas of the pancreas are rare and should suggest a metastasis to the pancreas from another organ.
Incorrect
Answer: Adenosquamous carcinoma
Histology: This invasive carcinoma has both glandular and squamous differentiation.
Discussion: Adenosquamous carcinoma of the pancreas is a highly aggressive malignant neoplasm with both glandular and squamous differentiation. The glandular differentiation can be highlighted with special stains for mucin. The cells of the squamous component have “hard” eosinophilic cytoplasm and prominent cell-cell junctions. In some instances keratin pearls can be seen. Adenosquamous carcinomas of the pancreas are highly aggressive neoplasms with a mean survival of only 6 months. Pure squamous carcinomas of the pancreas are rare and should suggest a metastasis to the pancreas from another organ.
