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Case 470 - Discussion

Uploaded: 2011-02-10, Updated: 2011-02-10

 

Chronic Pancreatitis Associated with IPMN

  • 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 diagnosis.