PMC3679691_01
CT abdomen with "sausage-shaped" pancreas.
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fig1
His pancreatic duct was normal in calibre (Figures 1 and 2).
CT abdomen revealing a bulky pancreatic head.
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fig2
His pancreatic duct was normal in calibre (Figures 1 and 2).
Portal vein narrowed with evidence of impingement on CT axial and sagittal images.
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fig3
The portal and superior mesenteric veins were significantly narrowed and impinged (Figure 3).
Endoscopic retrograde cholangiopancreatography (ERCP) images with dilated biliary tree down to a strictured distal bile duct.
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fig4
His intrahepatic and extrahepatic biliary tree was dilated to the lower third of the common bile duct (CBD), at which point the lower CBD appeared narrowed (Figure 4). 
An irregular hypoechoic area within the head of the pancreas above, which the common bile duct tapered.
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fig5
There was a 33 x 45 mm irregular hypoechoic area seen within the head of the pancreas, above which the CBD tapered (Figure 5).
EUS-guided FNA of the pancreatic mass.
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fig6
EU-guided fine-needle aspiration (FNA) biopsy of the head of the pancreas performed revealed loosely fibrous stromal tissue with mildly distorted, reactive ductal epithelial element, and lymphocytic infiltration (Figure 6).
Histopathology revealed carcinoma with squamous differentiation and some admixed tumour cells containing intracytoplasmic mucin.
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fig7
Histology revealed a moderately differentiated 30 mm adenosquamous carcinoma of the head of the pancreas with invasion of the duodenal wall and metastases into 4 of 40 lymph nodes; margins were clear, and his portal vein was clear with extensive changes of autoimmune pancreatitis (Figures 7 and 8).
Histopathology of areas with gland formation (adenocarcinoma).
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fig8
Histology revealed a moderately differentiated 30 mm adenosquamous carcinoma of the head of the pancreas with invasion of the duodenal wall and metastases into 4 of 40 lymph nodes; margins were clear, and his portal vein was clear with extensive changes of autoimmune pancreatitis (Figures 7 and 8).
Histopathology showed inflammatory, sclerosing process involving benign region of pancreatic tissue. There was fibrosis atrophy of exocrine elements and lymphoplasmacytic inflammation. Residual pancreatic islets are also present.
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fig9
The nonneoplastic portion of the pancreas showed extensive chronic pancreatitis with features consistent with autoimmune pancreatitis and squamous metaplasia (Figure 9).