This is a very interesting and difficult case. The patient had a
large non-invasive IPMN. In adjacent to the IPMN, there was a 2 cm
solid lesion that consisted of proliferation of pancreatic ducts
with occasional perineural invasion and localization around the
large vessels, the two features that are typically associated with
pancreatic adenocarcinoma. The stroma was somewhat desmoplastic.
However, the ducts were lack of significant atypia, and mostly
important, they were confined in a lobular configuration (more
lower power images will be provided later). Therefore, the overall
impression is that of a benign proliferative process, in stead of
a well-differentiated adenocarcinoma. I've sent this case to Dr.
Rhuban at John Hopkins Medical Center, and he agreed with the