PMC4823476_01
Computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) images. (a) arterial phase of dynamic CT revealed the enhanced tumor measuring 20 x 15 mm in size located in the head of the pancreas. (b) portal phase of dynamic CT also revealed the enhanced tumor measuring 20 x 20 mm in size. (c) arterial phase of dynamic MRI showed the rapid enhanced tumor in the head of the pancreas. (d) FDG-PET/CT revealed abnormal uptake only in the pancreas and the ileocecal lesions.
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Fluorodeoxyglucose positron emission tomography-CT (FDG-PET/CT) showed abnormal fluorodeoxyglucose-uptake in both lesions of the pancreas and ileum alone, without evidence of other metastatic deposits or endocrine lesions (Fig. 1).
Gross and microscopic features of pancreatic and ileal tumors. (a) The pancreatic tumor was observed as a gray-whitish round mass (arrows) on the excised surfaces. (b) The ileal tumor exhibited a yellowish polypoid tumor. (c) Relatively small-sized nests of tumor cells were observed in the pancreatic tumor. (d) Rounded nests of tumor cells with peripheral palisading were observed in the ileal tumor. (e, f) On immunohistochemistry, the tumor cells of both the pancreas (e) and ileum (f) were positive for synaptophysin. (g) The tumor cells of the pancreas were positive for pancreatic polypeptide. (h) The tumor cells of the ileum were positive for serotonin.Scale bars in (a) and (b) indicated 1 cm; (c, d) Hematoxylin-Eosin, x200; and (e-h) Immunohistochemistry with diaminobenzithin, x200.
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In the resected specimens, a whitish solid-nodular tumor in the pancreas head, measuring 14 x 13 x 12 mm size, and a yellowish solid-protruding tumor in the terminal ileum, measuring 21 x 7 x 15 mm size were found (Fig. 2). However, serotonin was positive only in the ileal tumor alone, whereas pancreatic polypeptide (PP) positivity was only observed in the pancreas tumor (Fig. 2).