A case of multicentric pancreatic mixed acinar-ductal carcinoma diagnosed by a yogurt-like cell clump flowing from the papilla of Vater

BMC Gastroenterology

Case Report

Hiroyuki Matsubayashi¹  Yoshihiro Kishida¹  Hiroyuki Ono¹  Akiko Todaka²  Shinsaku Honda³  Sunao Uemura³  Katsuhiko Uesaka³  Keiko Sasaki⁴ 

[1] Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, 411-8777, Shizuoka, Japan;Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan;Division of Hepato-Pancreato-Biliary Surgery, Shizuoka Cancer Center, Shizuoka, Japan;Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan;

关键词: Pancreas;    Mixed;    Acinar cell carcinoma;    Ductal adenocarcinoma;    Endoscopic retrograde pancreatography;    Biopsy;    Case report;   

DOI  :  10.1186/s12876-017-0575-z

 received in 2016-03-25, accepted in 2017-01-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHistological confirmation is needed when the pancreatic lesions is uncertain for neoplastic or nonneoplastic. Current case with multicentric pancreatic carcinomas showing indefinite clinical images was successfully diagnosed by a biopsy of a novel object expelled from the papilla.Case presentationA 71-year-old male was referred because of elevated serum pancreatic enzymes. Computed tomography revealed an unclear low-density area in the pancreatic body without evidence of tumor and mild dilation of the upstream main pancreatic duct (MPD). Other images, including abdominal ultrasound, endoscopic ultrasound, and magnetic resonance imaging, did not demonstrate cancerous findings. Endoscopic retrograde cholangiopancreatography showed a crab-claw-like obstruction in the MPD. Surprisingly, the component constituting the obstruction was moved by contrast injection and spilled out of the papilla orifice as a yogurt-like white object. Biopsy of this object by histology revealed a cancer cell clump. Pancreatectomy was performed, and pathology of the resected pancreas showed multiple nodular tumors replacing the acini and extending into the MPD. These neoplasms histologically resembled mixed acinar-ductal carcinoma.ConclusionCurrent report presented a rare tumor with multicentric pancreatic lesions, preoperatively diagnosed by a biopsy of an uncommon substance.

【 授权许可】

CC BY   
© The Author(s). 2017