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A case of pancreatic ductal adenocarcinoma with marked infiltration with IgG4-positive cells.

Yoneda M, Inada H, Kanayama K, Shiraishi T - J Cytol (2013)

Bottom Line: A 75-year-old man was diagnosed as having pancreatic ductal carcinoma containing remarkable lymphocytic and plasma cell infiltration, as revealed by the cytological examination of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) specimen.A pancreatic resection was performed, and the histopathological features showed an invasive pancreatic ductal carcinoma with autoimmune pancreatitis (AIP) lymphoplasmacytic sclerosing pancreatitis (LPSP)-like lesions.Most of the plasma cells were immunoreactive to anti-IgG4 antibody.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathologic Oncology, Institute of Molecular and Experimental Medicine, Faculty of Medicine, Mie University Graduate School of Medicine, Japan.

ABSTRACT
A 75-year-old man was diagnosed as having pancreatic ductal carcinoma containing remarkable lymphocytic and plasma cell infiltration, as revealed by the cytological examination of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) specimen. The EUS-FNA specimen showed small amounts of atypical epithelium with noticeable lymphocytes and plasma cells. A pancreatic resection was performed, and the histopathological features showed an invasive pancreatic ductal carcinoma with autoimmune pancreatitis (AIP) lymphoplasmacytic sclerosing pancreatitis (LPSP)-like lesions. Most of the plasma cells were immunoreactive to anti-IgG4 antibody. EUS-FNA may be necessary for the differential diagnosis of AIP and pancreatic cancer, and close attention should be given to the presence of marked lymphoplasmacytic cells in EUS-FNA specimens while making the diagnosis.

No MeSH data available.


Related in: MedlinePlus

(a) Numerous lymphocytes and plasma cells with necrotic material and fibrosis are visible (Diff-Quik, ×400); (b) Atypical epithelial cells (Diff-Quik, ×1000); (c) The cut surface of the resected specimen show an elastic, hard, white mass that was located in the pancreas tail; (d) Ductal adenocarcinoma with lymphoplasmacytic infiltration was visible (H and E, ×100); (e) Immunohistochemical findings showed abundant IgG4-positive plasma cells around the pancreatic duct and cancer cells (IHC, ×100)
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Figure 1: (a) Numerous lymphocytes and plasma cells with necrotic material and fibrosis are visible (Diff-Quik, ×400); (b) Atypical epithelial cells (Diff-Quik, ×1000); (c) The cut surface of the resected specimen show an elastic, hard, white mass that was located in the pancreas tail; (d) Ductal adenocarcinoma with lymphoplasmacytic infiltration was visible (H and E, ×100); (e) Immunohistochemical findings showed abundant IgG4-positive plasma cells around the pancreatic duct and cancer cells (IHC, ×100)

Mentions: Smear preparations of the EUS-FNA materials from the pancreas tumor were stained using Diff-Quik solution. Cytoblocks were made by allowing the aspirated materials to clot in 10% buffered formalin, followed by treatment in alginic acid. The smear preparations showed numerous lymphocytes including plasma cells with necrotic material [Figure 1a] and small clusters of atypical epithelial cells [Figure 1b]. The atypical cells had a high nuclear to cytoplasmic ratio; the cells were hyperchromatic and contained prominent nucleoli. The Papanicolaou-stained smear preparations and the cytoblock preparations showed similar findings. In the cytoblock specimens, some plasma cells were immunoreactive to anti-IgG4 antibody.


A case of pancreatic ductal adenocarcinoma with marked infiltration with IgG4-positive cells.

Yoneda M, Inada H, Kanayama K, Shiraishi T - J Cytol (2013)

(a) Numerous lymphocytes and plasma cells with necrotic material and fibrosis are visible (Diff-Quik, ×400); (b) Atypical epithelial cells (Diff-Quik, ×1000); (c) The cut surface of the resected specimen show an elastic, hard, white mass that was located in the pancreas tail; (d) Ductal adenocarcinoma with lymphoplasmacytic infiltration was visible (H and E, ×100); (e) Immunohistochemical findings showed abundant IgG4-positive plasma cells around the pancreatic duct and cancer cells (IHC, ×100)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643362&req=5

Figure 1: (a) Numerous lymphocytes and plasma cells with necrotic material and fibrosis are visible (Diff-Quik, ×400); (b) Atypical epithelial cells (Diff-Quik, ×1000); (c) The cut surface of the resected specimen show an elastic, hard, white mass that was located in the pancreas tail; (d) Ductal adenocarcinoma with lymphoplasmacytic infiltration was visible (H and E, ×100); (e) Immunohistochemical findings showed abundant IgG4-positive plasma cells around the pancreatic duct and cancer cells (IHC, ×100)
Mentions: Smear preparations of the EUS-FNA materials from the pancreas tumor were stained using Diff-Quik solution. Cytoblocks were made by allowing the aspirated materials to clot in 10% buffered formalin, followed by treatment in alginic acid. The smear preparations showed numerous lymphocytes including plasma cells with necrotic material [Figure 1a] and small clusters of atypical epithelial cells [Figure 1b]. The atypical cells had a high nuclear to cytoplasmic ratio; the cells were hyperchromatic and contained prominent nucleoli. The Papanicolaou-stained smear preparations and the cytoblock preparations showed similar findings. In the cytoblock specimens, some plasma cells were immunoreactive to anti-IgG4 antibody.

Bottom Line: A 75-year-old man was diagnosed as having pancreatic ductal carcinoma containing remarkable lymphocytic and plasma cell infiltration, as revealed by the cytological examination of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) specimen.A pancreatic resection was performed, and the histopathological features showed an invasive pancreatic ductal carcinoma with autoimmune pancreatitis (AIP) lymphoplasmacytic sclerosing pancreatitis (LPSP)-like lesions.Most of the plasma cells were immunoreactive to anti-IgG4 antibody.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathologic Oncology, Institute of Molecular and Experimental Medicine, Faculty of Medicine, Mie University Graduate School of Medicine, Japan.

ABSTRACT
A 75-year-old man was diagnosed as having pancreatic ductal carcinoma containing remarkable lymphocytic and plasma cell infiltration, as revealed by the cytological examination of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) specimen. The EUS-FNA specimen showed small amounts of atypical epithelium with noticeable lymphocytes and plasma cells. A pancreatic resection was performed, and the histopathological features showed an invasive pancreatic ductal carcinoma with autoimmune pancreatitis (AIP) lymphoplasmacytic sclerosing pancreatitis (LPSP)-like lesions. Most of the plasma cells were immunoreactive to anti-IgG4 antibody. EUS-FNA may be necessary for the differential diagnosis of AIP and pancreatic cancer, and close attention should be given to the presence of marked lymphoplasmacytic cells in EUS-FNA specimens while making the diagnosis.

No MeSH data available.


Related in: MedlinePlus