Clinical History A 73-year-old female with a history of monoclonal gammopathy of undetermined significance (MGUS) and small fiber peripheral neuropathy was found to have elevated transaminases and alkaline phosphatase (ALP) – ALT 54 U/L (normal range 15-41), AST 66 U/L (normal range 14-54), ALP 322 U/L (normal range 38-126) on routine laboratory testing. Total bilirubin […] Read more…

Clinical History A 58-year-old woman with no significant past medical history developed left abdominal pain. An abdominal MRI showed an irregular enhancing 4.5 x 4.0 cm pancreatic tail mass that was inseparable from vessels in the splenic hilum. Endoscopic ultrasound-guided fine-needle aspiration showed rare malignant cells, favoring adenocarcinoma. The patient subsequently underwent neoadjuvant therapy with […] Read more…

Clinical History A 38-year-old female with a history of hypertension presented to the emergency department with complaints of nausea, vomiting, and back pain. MRI showed a T1 hypointense, T2 hyperintense, nonenchancing cystic lesion at the tail of the pancreas, which caused mass effect upon the spleen and stomach. A distal pancreatectomy was subsequently performed. The […] Read more…

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…