PMC5099278_01
Triphasic abdominal CT with contrast, (coronal and axial view) revealed large well defined, partially solid/cystic mass at pancreatic tail.
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Triphasic abdominal CT with contrast revealed large well defined mass at pancreatic tail, about 12 x 11.6 cm, partially solid/cystic, compressing the pancreatic tissue and the splenic vein was seen stretched on outer surface of the mass (Fig. 1).
Opening of the lesser sac and exposure of the pancreatic EGIST mass.
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Firstly, opening of the lesser sac along the greater curvature of stomach was done for exposing the pancreatic mass (Fig. 2).
Ligation and clipping of the splenic artery.
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Double ligation and clipping of splenic artery was performed (Fig. 3).
Transection of the pancreas using laparoscopic Endo GIA stapler.
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Transection of the pancreas using laparoscopic Endo GIA stapler 60 mm (Fig. 4).
Histomicrographs of GIST. A, The neoplastic proliferation and the adjacent panreaticacini (blue arrow) can be seen (H&E x200). B, The tumor is formed of spindle cell proliferation in fasicular pattern with oval shaped nuclei (H&E x200). C, The neoplastic cells showed positive cytoplasmic staining for CD117 (IHCx200). D, The tumor cells showed positive cytoplasmic staining for DOG1 (IHC x400). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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Microscopically, the tumor was formed of spindle cell proliferation in fasicular pattern with oval shaped nuclei (Fig. 5A&B). Immunohistochemical staining revealed positive immunoreactivity of the tumor cells for CD117 (Fig. 5C) and DOG-1 (Fig. 5D) while smooth muscle actin,