A resected case of pancreatic adenosquamous carcinoma in which both adenocarcinoma and squamous cell carcinoma components were confirmed by liquid-based cytology

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  • SHINODA Yukako
    Department of Diagnostic Pathology, Kurume University Hospital
  • NAITO Yoshiki
    Department of Clinical Laboratory Medicine, Kurume University Hospital
  • ABE Hideyuki
    Department of Diagnostic Pathology, Kurume University Hospital
  • TAKASE Yorihiko
    Department of Diagnostic Pathology, Kurume University Hospital
  • MURATA Kazuya
    Department of Diagnostic Pathology, Kurume University Hospital
  • MAKINO Ryo
    Department of Diagnostic Pathology, Kurume University Hospital
  • KUMAGAE Takato
    Department of Diagnostic Pathology, Kurume University Hospital
  • OKABE Yoshinobu
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • KAWAHARA Akihiko
    Department of Diagnostic Pathology, Kurume University Hospital
  • AKIBA Jun
    Department of Diagnostic Pathology, Kurume University Hospital

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  • 液状化検体細胞診で腺癌成分と扁平上皮癌成分を確認しえた膵腺扁平上皮癌の 1 切除例

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<p>Background : Pancreatic adenosquamous carcinoma (PASC) is a malignant tumor consisting of both adenocarcinoma (AC) and squamous cell carcinoma (SCC) components. Since both components are rarely observed at the same time in cytological smears, cytological diagnosis is often difficult. Herein, we report a case of PASC in which both the AC and SCC components could be confirmed in the tumor using liquid-based cytology (LBC).</p><p>Case : The patient was a man in his 60 s who was detected to have a mass in the head of the pancreas while receiving chemoradiotherapy for esophageal cancer. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy was performed, and a squash preparation of the specimens revealed both clusters of atypical cells, and a small component of SCC cells with keratinization. Both the SCC and AC components were confirmed by LBC. The SCC component showed positive immunocytochemical staining for p40, and the tumor was suspected as a PASC. In the resected specimen, the tumor was composed of an AC component with clear formation of glandular structures and an SCC component with cells showing an irregular alveolar growth pattern ; based on these findings, the tumor was confirmed as a PASC.</p><p>Conclusion : Understanding the cytological characteristics of AC and SCC is important for the diagnosis of PASC. In addition, the use of LBC with high quality cell collection by EUS-FNA and immunocytochemistry for p40 are useful for confirming the non-keratinized SCC component.</p>

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