Case 34

Surgical Pathology Case
Clinical Information
  68 year-old lady with epigastric pain for several months with a weight loss of 15 pounds. CAT and ultrasound studies revealed a mass of pancreatic head, and CA-199 was 290.
Gross Description

The specimen consists of the distal stomach measuring 10.0 cm long and 6.0 cm in diameter, duodenum and jejunum measuring 31.0 cm long and 3.0 cm in diameter, and the pancreatic head measuring 4.0 x 5.0 x 3.0 cm. Upon opening the specimen the gastric wall measures up to 0.5 cm thick. The mucosal surface of the stomach and duodenum are unremarkable. The common bile duct and the pancreatic duct open into the duodenum separately. Sectioning through the pancreas reveals one tan-white 3.5 x 3.0 x 3.5 cm tumor mass in the head of the pancreas, which infiltrates the main pancreatic duct, the common bile duct and the duodenal muscularis. The tumor is within 0.3 cm from the pancreatic dissection margin. The remaining pancreatic tissue is firm and nodular.

    HE, 4
  HE, 20 HE, 10

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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan