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Presented by Ralph Hruban, M.D. and prepared by Whitney Green, M.D.
Case 2: This 50 some year old patient presented with a history of abdominal pain.
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Question 1 of 1
1. Question
Week 576: Case 2
This 50 some year old patient presented with a history of abdominal pain. Imaging revealed a 5cm mass in the head of the pancreas.images/Case2_image1RH.jpg
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images/Case2_image5RH.jpgCorrect
Answer: Acinar cell carcinoma
Histology: This is a solid cellular neoplasm. In some areas the neoplastic cells form shetts, in other areas subtle acini. Some of the nuclei, but by no means all, have single prominent nucleoli. An immunostain for BCL-10 was strongly positive.
Discussion: As demonstrated by this case, acinar cell carcinomas can form acini, or they can grow as sheets of neoplastic cells. The single prominent nucleoli can be a clue to the diagnosis. In addition to the traditional panel of immunostains, immunolabeling for BCL-10 has been shown to help in establishing the diagnosis of an acinar cell carcinoma.
Reference(s):
– LaRosa et at, Virchow Archives, 2009; 454:133-14Incorrect
Answer: Acinar cell carcinoma
Histology: This is a solid cellular neoplasm. In some areas the neoplastic cells form shetts, in other areas subtle acini. Some of the nuclei, but by no means all, have single prominent nucleoli. An immunostain for BCL-10 was strongly positive.
Discussion: As demonstrated by this case, acinar cell carcinomas can form acini, or they can grow as sheets of neoplastic cells. The single prominent nucleoli can be a clue to the diagnosis. In addition to the traditional panel of immunostains, immunolabeling for BCL-10 has been shown to help in establishing the diagnosis of an acinar cell carcinoma.
Reference(s):
– LaRosa et at, Virchow Archives, 2009; 454:133-14
