PMC6606020_01
Fine needle aspiration cytology showed a highly cellular specimen consisting of a monotonous population of single cells and clusters of cells with a moderate amount of basophilic cytoplasm (a). The nuclei are round to oval with moderate anisonucleosis and a single prominent nucleolus (arrows) (b). Histologically the tumor showed extensive intraductal growth in the main pancreatic duct (PD) and side branches (SB) (c). The tumor was composed of uniform cells with granular cytoplasm and nucleoli with a single prominent nucleolus (arrows), forming small lumina (d). Immunohistochemically, the tumor cells were strongly positive for BCL10 (e) and negative for Chromogranin A (f). Note the opposite staining patterns in the adjacent islets of Langerhans (arrows). PD, pancreatic duct; SB, side branch of pancreatic duct.
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F0001
Endoscopic ultrasound with fine-needle aspiration cytology was performed and showed cytology consistent with ACC (Figure 1(a,b)). The patient underwent total pancreatectomy and histological examination confirmed an ACC with extensive intraductal spread (Figure 1(c,d)).