PMC5933473_01
(A) 10 x 8 cm thick walled lesion with multiple thick internal septations and both cystic and solid components in the tail of the pancreas. (B) Splenic vein compression by the mass.
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(A) Representative HE stained section of MCN demonstrating moderate grade (arrow) to high-grade (arrowhead) dysplasia and ovarian stroma (star) (10 x ). (B) Area of invasive pancreatic adenocarcinoma (arrow) within MCN (10 x ). (C) Representative HE region of highly cellular stroma within MCN specimen (20 x ). (D) Cellular stroma staining CK positive indicating epithelial cell type origin (20 x ). (E, F) Representative lymph node HE and CK stain showing CK-positive cells invading lymph node tissue (20 x ). CK, cytokeratin; HE, hematoxylin and eosin; MCN, mucinous cystic neoplasm.
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Areas of undifferentiated malignancy with sarcomatous features were noted in some of the last histological sections (Fig. 2C). The lesion was negative for all mesenchymal markers but strongly positive for cytokeratin (CK), indicating an epithelial malignancy consistent with anaplastic pancreatic carcinoma (APC) (Fig. 2D). Three of 38 peripancreatic lymph nodes were positive for APC, highlighted on CK stain (Fig. 2E, F).