Pancreatobiliary Pathology Society

case presentation

Case #8: Quarter 3, 2020

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…

Case #7: Quarter 2, 2020

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…

Case #6: Quarter 1, 2020

Figure 4. H&E stain

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…

Case #5: Quarter 4, 2019

Figure 2: H&E section of tumor, in relation to duodenum (original magnification 4X)

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…

Case #4: Quarter 3, 2019

Figure 2. Low power image of gallbladder, focused on perimuscular soft tissue. Inset: medium power image of area with arrow. (Click image to see full size)

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…

Case #3: Quarter 2, 2019

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…

Case #2: Quarter 1, 2019

Figure 6. High power image of pancreatic mass (H&E (left) and Elastin stain (right), 400x magnification).

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

Case1 Figure1 4x

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…