EURORAD ESR

Case 10843

An infrequent pancreatic neoplasm in a young patient

Author(s)
Maria Inês Leite1, José Fonseca Santos1, Luísa Lobo1, António Alves2, Isabel Távora1

1- Radiology department of Hospital de Santa Maria, Lisbon, Portugal
2- Pathology department of Hospital de Santa Maria, Lisbon, Portugal
 
Patient
female, 17 year(s)
 
 
  • Figure 1
    Abdominal ultrasonography scans in axial (a) and longitudinal planes (b).

    Unilocular cyst detected in the pancreatic tail and presenting an irregular and thick wall.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Axial pre (a) and postcontrast (b,c) CT images.

    The cystic lesion presented no intratumoural septa nor calcifications. Despite being well-demarcated, it had a thickened wall that showed early contrast enhancement. The remaining pancreatic parenchyma was unremarkable.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    MR imaging:T1WI(a), fat-suppressedT2WI(b),MRCP(c).

    The signal intensity of the cystic component was suggestive of simple fluid. There was no visible communication with the ductal system. Note mild dilatation of the pancreatic duct proximal to the cystic mass.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Microscopic findings. H&E (400x).

    The tumour consisted predominantly of diffuse sheets of large cells, with eosinophilic cytoplasm, “salt-and-pepper” chromatin pattern and visible nucleoli. Atypical mitosis can be seen.

     
    Area of Interest: Abdomen; Imaging Technique: Absorptiometry / Bone densiometry; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 5
    Microscopic findings. Anti-chromogranin A immunostaining (400x)

    The tumour cells were positive for cytoqueratins and neuroendocrine markers, namely chromogranin A, synaptophysin and CD56.

     
    Area of Interest: Abdomen; Imaging Technique: Absorptiometry / Bone densiometry; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 6
    Microscopic findings. Anti-Ki67 immunostaining (400x)

    A proliferative index of >20% of the tumour cells is detected.

     
    Area of Interest: Abdomen; Imaging Technique: Echocardiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Unilocular cyst detected in the pancreatic tail and presenting an irregular and thick wall.
 
The cystic lesion presented no intratumoural septa nor calcifications. Despite being well-demarcated, it had a thickened wall that showed early contrast enhancement. The remaining pancreatic parenchyma was unremarkable.
 
The signal intensity of the cystic component was suggestive of simple fluid. There was no visible communication with the ductal system. Note mild dilatation of the pancreatic duct proximal to the cystic mass.
 
The tumour consisted predominantly of diffuse sheets of large cells, with eosinophilic cytoplasm, “salt-and-pepper” chromatin pattern and visible nucleoli. Atypical mitosis can be seen.
 
The tumour cells were positive for cytoqueratins and neuroendocrine markers, namely chromogranin A, synaptophysin and CD56.
 
A proliferative index of >20% of the tumour cells is detected.
 
 
 
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