Two cases of anaplastic carcinoma of the pancreas

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  • 膵に発生した退形成癌の 2 例

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<p>Background : Anaplastic carcinoma is a rare tumor and carries a poor prognosis. Herein, we report two cases of anaplastic carcinoma of the pancreas.</p><p>Cases : Case 1 : A female patient in her 70 s was detected to have a tumor in the pancreatic head by abdominal ultrasonography performed during a follow-up visit after a cardiac operation.</p><p>Case 2 : A female patient in her 70 s was admitted to hospital complaining of abdominal pain. Abdominal computed tomography (CT) revealed a tumor in the pancreatic head.</p><p>Endoscopic ultrasound-fine needle aspiration (EUS-FNA) biopsy was performed in both patients.</p><p>Cytologically, round and spindle-shaped tumor cells were seen, either scattered, in clusters, or arranged in sheets. Osteoclast-like giant cells were also recognized.</p><p>On gross examination, both tumors showed severe hemorrhage and necrosis on cut surface.</p><p>Histological examination revealed proliferation of spindle-shaped and polygonal tumor cells with prominent nucleoli and irregular nuclear contour arranged in a disarray or in a solid sheets. Small foci of adenocarcinoma were also seen. Osteoclast-like giant cells were prominent in the hemorrhagic areas. In Case 1, cartilaginous matrix was also seen.</p><p>On immunohistochemical examination, the spindle-shaped cells and polygonal cells showed positive staining for vimentin and CAM5.2, while the osteoclast-like giant cells showed positive staining for CD68.</p><p>Based on above findings both tumors were diagnosed as anaplastic carcinoma.</p><p>Conclusion : Identification of spindle-shaped/round tumor cells and osteoclast-like multinucleated giant cells on pancreatic cytology should suggest the possibility of anaplastic carcinoma in the differential diagnosis.</p>

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