PMC6000869_01
The preoperative abdominal CT scan exhibited a hypodense lesion in the pancreas head and neck (the black arrow indicates the mass).
CRIM2018-1510759.001.jpg
PMC6000869_01_CRIM2018-1510759.001.jpg
fig1
The abdominal CT scan with contrast exhibited an 18 mm x 20 mm hypodense mass at the head and neck of the pancreas (Figure 1).
Endosonographic imaging exhibited a hypoechoic lesion at the ampulla.
CRIM2018-1510759.002.jpg
PMC6000869_01_CRIM2018-1510759.002.jpg
fig2
Also, endosonographic imaging was performed to rule out periampullary lesions (Figure 2).
(a) Microscopic sections reveal the proliferation of mesenchymal cells in a storiform pattern. Cells consist of two populations including spindle fibroblast-like and pleomorphic cells. (b) The giant cells are positive for CD68 marker. (c) The cells exhibit the diffuse positive reaction to vimentin.
CRIM2018-1510759.003.jpg
PMC6000869_01_CRIM2018-1510759.003.jpg
fig3
In addition, the proliferation pattern of the mesenchymal cells was storiform (Figure 3(a)). The immunohistochemical staining was performed, and the tumor was positive for CD68, lysozyme, alpha 1-antichymotrypsin, and vimentin (Figure 3).