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Presented by Ralph Hruban, M.D. and prepared by Shien Micchelli, M.D.
Case 6: This elderly woman lost 20 pounds and had vague abdominal pain.
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1. Question
Week 288: Case 6
This elderly woman lost 20 pounds and had vague abdominal pain. A CT scan revealed a 3 cm mass in the head of the pancreas./images/10_30_06_6a.jpg
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/images/10_30_06_6e.jpgCorrect
Answer: Progression to invasive pancreatic cancer in a single duct
Histology: This single duct shows the full spectrum of differentiation from normal epithelium, to a non-invasive epithelium with significant architectural and cytologic atypia, to invasive cancer.
Discussion: Histologically well-define precursor lesions have been identified in the pancreas. These lesions are called “Pancreatic intraepithelial neoplasia” or PanIN for short. In this case, the entire “progression model” for the development of invasive pancreatic cancer is seen in a single duct.
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Answer: Progression to invasive pancreatic cancer in a single duct
Histology: This single duct shows the full spectrum of differentiation from normal epithelium, to a non-invasive epithelium with significant architectural and cytologic atypia, to invasive cancer.
Discussion: Histologically well-define precursor lesions have been identified in the pancreas. These lesions are called “Pancreatic intraepithelial neoplasia” or PanIN for short. In this case, the entire “progression model” for the development of invasive pancreatic cancer is seen in a single duct.
