PMC2782216_01
(A) An abdominal computerized tomography reveals the presence of a large cystic mass, arising from the tail of pancreas. (B) The resected tumor is a 8x7x6-cm hemorrhagic and cystic mass in the tail of the pancreas.
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F1
An abdominal computerized tomography revealed the presence of a large cystic mass, arising from the tail of pancreas (Fig. 1A). The resected tumor was a 8x7x6-cm hemorrhagic and cystic mass in the tail of the pancreas, mimicking pancreatic pseudocyst (Fig. 1B).
Histologically, the tumor is composed of typical ductal adenocarcinoma (closed arrow) and surrounding mononuclear stromal cells (open arrow) intermingled with osteoclast-like giant cells (closed arrow head) and pleomorphic large cells (open arrow head) (H&E x200).
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F2
Histologically, the tumor was composed of typical ductal adenocarcinoma and surrounding mononuclear stromal cells intermingled with osteoclast-like giant cells and pleomorphic large cells (Fig. 2).
Immunohistochemical staining of cytokeratin (A) and CD-68 (B). Cytokeratin (CK) is strongly positive for ductal carcinoma cells, whereas both osteoclast-like giant cells and mononuclear cells are negative for CK. However, osteoclast-like giant cells and mononuclear cells are positive for histiocytic markers, CD-68 (x200).
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F3
Immunohistochemically, cytokeratin (CK) and epithelial membrane antigen (EMA) are strongly positive for ductal carcinoma cells, whereas both osteoclast-like giant cells and mononuclear cells were negative for CK (Fig. 3A) and EMA. Osteoclast-like giant cells and mononuclear cells were positive for histiocytic markers, CD-68 (Fig. 3B) and lysozyme.
Electron microscopically, the nucleus of the mononuclear cell contains prominent nucleoli, with dispersed clumps of heterochromatin. The cytoplasm contained ample mitochondria, and moderate amount of rough endoplasmic reticulum (x4,000).
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F4
The cytoplasm contained ample mitochondria, and moderate amount of rough endoplasmic reticulum (Fig. 4) (Table 2).
Electron microscopically, osteoclast-like giant cell has multiple nuclei with dispersed chromatin and a fine chromatin rim. The cytoplasm is characterized by abundant mitochondria of varying size, free ribosomes, and dilated empty rough endoplasmic reticulum cisternae (x4,000).
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F5
The cytoplasm was characterized by abundant mitochondria of varying size, free ribosomes, and dilated empty rough endoplasmic reticulum cisternae (Fig. 5) (Table 2).