Clinical History A 24-year-old female presented to the emergency department with severe left-sided abdominal pain. CT abdomen/pelvis showed a heterogeneous mass in the tail of the pancreas with multiple metastatic liver lesions and lymphadenopathy. Liver lesion biopsies were attempted and yielded necrotic debris with outlines of atypical cells that were positive for pancytokeratin (AE1/AE3). The […] Read more…

Clinical History A 58-year-old male with no past medical history presenting to the emergency department with 2-month history of increasingly severe generalized abdominal pain accompanied by intermittent “stabbing sensations” with or without eating. The patient states the pain is so severe he has been unable to sleep and over the past few weeks he has […] Read more…

Clinical details: 74-year-old man was presented with jaundice, progressive anemia, dark urine, melena, and a reported weight loss of 10 kilograms in 2 weeks. His comorbidities included mild chronic renal failure, diverticulosis, and dyslipidemia. He was previously a smoker (20 cigs/day, stopped 35 years ago). On examination, his BMI was 26.1, Hb: 8.7 g/dl, bilirubin […] Read more…

History: A female in mid-fifties underwent cholecystectomy due to cholelithiasis. No significant previous medical history was noted. Macroscopy: Grossly, gallbladder wall was mildly thickened, and serosal surface was ragged. Open sectioning, there were several yellowish calculi within the lumen but, no mass lesion was identified. Microscopy: The microscopic findings are shown below (Figures 1-4).   […] Read more…

History: 59 year-old man with a 5.0 cm mass in the head of the pancreas Pancreaticoduodenectomy: The patient underwent pancreaticoduodenectomy, which showed a 5.0 cm well circumscribed mass confined in the head of the pancreas. The cut surface of the tumor is tan, soft with mixed areas of necrosis and hemorrhage. The following images (Figure […] Read more…

History: A 69-year-old African American female had chronic epigastric and back pain post hiatal hernia repair. Radiology: Abdominal computed tomography scan was performed and revealed a 2.5 cm, solid pancreatic tail mass with associated pancreatic duct dilation. Radiologically this was suspicious for either pancreatic ductal adenocarcinoma or a neuroendocrine tumor. FNA: Endoscopic ultrasound-guided fine needle […] Read more…

CASE # 1: QUARTER 4, 2018 A 57-year-old male, with a history of bladder and prostate cancer, and pancreatitis, presents with dark urine and clay-colored floating stools. Labs were notable for white blood cell count 5900, lipase 449, alkaline phosphatase 731, total bilirubin 6.3, AST 381, and ALT 991. CA 19-9 was elevated at 184 […] Read more…