PMC9294444_01
Axial view of FDG-PET/CT: (A) Hypermetabolic activity in the swollen pancreas with SUVmax of 3.0; (B) Mild hypermetabolic activity surrounding the pancreas; (C) Mild hypermetabolic activity in the mesenteric area with SUVmax of 1.9.
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F1
Whole-body fluorodeoxyglucose PET/CT scans showed pancreatic thickening along with increased fluorodeoxyglucose tracer intake, pancreatic duct dilation, and a mild increase in the metabolic activity of lymph nodes in the peripancreatic and mesenteric areas (Figure 1).
Micrographs of the surgical specimens and immunohistochemical examination results. (A,B) Sections of the pancreas showed atypical clear cells monomorphonuclear with bright cytoplasm (H&E, x20, x100). (C-E) HE staining image of the peripancreatic lymph node, sections of the liver, and the omental tissue showed histological features similar to those of the pancreatic sections (H&E, x100, x100, x100). (F-I) Immunohistochemical examination of surgical specimens showed neoplastic cells with CK (+), CA9 (+), CD10(+), and Vimentin (+) (x100).
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F2
The results of histopathological and immunohistochemical analyses are provided in Figure 2.
Newly-occurred lung metastases after metastasectomy. (A) No lung metastases before metastasectomy. (B) The metastatic lesion in the right lower lobe (arrow) 10 months after metastasectomy.
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F3
In June 2020, the high-resolution chest CT re-examination revealed new nodules in the basal segment of the right lower lobe (Figure 3).
Enhanced CT scan showing multiple abnormal enhancement lesions (arrows). (A) The mass with heterogeneous enhancement in left kidney area. (B) A 'target-like' sign and heterogeneous enhancement of the nodule in liver. (C) Multiple enlarged lymph nodes in hepatic hilar region.
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F4
In September 2020, a reexamination of the abdominal enhanced CT showed that there were multiple new-onset metastatic lesions in the left renal area, the liver, and the lymph nodes in the hilar area (Figure 4).