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Presented by Ralph Hruban, M.D. and prepared by Lynette S. Nichols, M.D.
Case 4: This 75 year old man presented with an ill-defined mass in the pancreas.
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1. Question
Week 106: Case 4
This 75 year old man presented with an ill-defined mass in the pancreas./images/Lyn’s/9-2-02-Hruban-4.a.jpg
/images/Lyn’s/9-2-02-Hruban-4.b.jpg
/images/Lyn’s/9-2-02-Hruban-4.c.jpgCorrect
Answer: Infiltrating Ductal Adenocarcinoma
Histology: A gland without dramatic atypia is seen in close association to a vessel without intervening acini.
Discussion: In the pancreas, ducts and blood vessels do not normally travel together, but are separated in pancreatic lobules. K.B. Green and S. Sharma reported at this year’s USCAP Meeting in Chicago that the presence of a well-differentiated duct-like structure near vessels without intervening acini is virtually diagnostic of an infiltrating ductal adenocarcinoma of the pancreas.
Incorrect
Answer: Infiltrating Ductal Adenocarcinoma
Histology: A gland without dramatic atypia is seen in close association to a vessel without intervening acini.
Discussion: In the pancreas, ducts and blood vessels do not normally travel together, but are separated in pancreatic lobules. K.B. Green and S. Sharma reported at this year’s USCAP Meeting in Chicago that the presence of a well-differentiated duct-like structure near vessels without intervening acini is virtually diagnostic of an infiltrating ductal adenocarcinoma of the pancreas.
