PMC5999014_01
CT and MRI. (A) CT revealed a 6-cm hypovascular tumor in the pancreatic tail, indicated by white arrow. (B, C) Calcification was detected at the edge of the tumor. Yellow circles indicate calcification. (D, E) MRI showed hypointensity of the tumor on T1-weighted images (D), and hyperintensity on T2-weighted images (E); tumor indicated by white arrows. CT, computed tomography; MRI, magnetic resonance imaging.
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A 72-year-old-woman was admitted to our hospital with a 6 x 4.5 cm huge tumor in which an artery was penetrating in the pancreatic tail (Fig. 1A, white arrows). Contrast-enhanced computed tomography revealed calcification at the edge of the tumor (Fig. 1B, C), no cystic lesion, and gradual enhancement. Magnetic resonance imaging revealed hypointensity of the tumor on T1-weighted images (Fig. 1D) and hyperintensity on T2-weighted images (Fig. 1E).
EUS-FNA and histological analysis. (A) EUS-FNA was performed against the clear boundary of the low echoic mass. (B-D) Spindle-shaped cells were detected by hematoxylin-eosin staining (B: original magnification x40, and C: original magnification x200); these cells were positive for S-100 (D: original magnification x200). EUS-FNA, endoscopic ultrasonography-guided fine needle aspiration; HE, hematoxylin and eosin stain.
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Therefore, EUS-FNA was performed (Fig. 2A), and spindle-shaped cells (Fig. 2B, C) that were immunopositive for S-100 (Fig. 2D) and negative for c-kit, CD34, and desmin were detected.