PMC2676326_01
Abdominal CT scan with IV contrast demonstrating a cystic mass in the head of the pancreas. (a) Arterial phase, (b) venous phase, (c) three dimensional coronal CT reconstruction of the celiac axis illustrating resectability, and (d) three dimensional CT reconstruction of the porta hepatis.
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A computed tomography (CT) scan at our institution demonstrated a 6.2 by 5.3 cm mass in the pancreatic head (Figures 1(a) and 1(b)). The mass was distinct from the mesenteric vessels and therefore likely resectable (Figures 1(c) and 1(d)).
(a) Gross pathology specimen. 5.5 cm hemangioma containing denuded multiloculated cysts (C) with intracystic hemorrhage. Pancreatic acinar tissue (P). (b) Hematoxylin and eosin stain (160x) of specimen demonstrating cyst lumen (L) lined with endothelial intima (arrow) and surrounded by media rich in hyalinized collagen (H). (c) CD31 stain (160x) of specimen with strong staining of endothelial intima (arrow). Blood in cyst lumen (B).
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Gross pathologic examination revealed a 5.5 cm hemangioma predominantly composed of denuded multiloculated cysts containing intracystic hemorrhage (Figure 2(a)). Immunolabeling revealed that this lining was positive for CD 31, focally positive for CD34 and negative for cytokeratin (AE1/AE3), supporting the diagnosis of hemangioma (Figures 2(b), 2(c)).