Slide 123.Adenocarcinoma, Pancreas

A. Brief Descriptions

  1. Ductal adenocarcinoma of the exocrine pancreas comprises about 85% of pancreatic malignancy.

  2. Most arise in the head of the pancreas (60%).

  3. Ductal epithelial origin.

  4. Extrapancreatic extension is common.

B. Gross Findings

  1. Poorly delineated ,firm with a yellowish gray cut surface, extrapancreatic extension is common.

C. Micro Findings

  1. Destruction of pancreatic lobules with neoplastic glands.

  2. Well-formed neoplastic glands with larger lumen and lined by one or more layers of epithelium which show cellular atypia.

  3. Irregularity in the shape and distribution of these neoplastic glands surrounded with desmoplastic stroma (extensive desmoplastic reaction).

D. Others:

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E. Reference

  1. Robbins Pathologic Basis of Disease, 6th ed.  P.910-911.

 

 

 

Fig. 123-1 (LP)The pancreatic parenchyma is infiltrated by irregular glandular structure.

 

 

 

Fig. 123-2 (LP)Irregular cancerous glands infiltrating in interlobular stroma and in pancreatic lobules.

 

 

 

Fig. 123-3 (LP)The normal architecture of pancreas is destructed by the infiltration of cancer glands. Note remainder pancreatic acini in middle left.

 

 

 

Fig. 123-4 (HP)The cancerous glands extend into pancreatic lobules.

 

 

 

Fig. 123-5 (HP)Stromal desmoplasia is prominent.

 

 

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