PMC4854227_01
Haematoxilin/eosin-stained pancreatic cytology revealed the presence (A) of poorly cohesive, pleomorphic, monucleated or multinucleated large cells (20x). Positivity (B) for cytokeratins AE-AE2 confirms the diagnosis of anaplastic cell carcinoma (20x). Peritoneal washing cytology (PWC) with Papanicolaou stain (C) detects cells with malignant features such as nuclear displacement, irregular nuclear membranes, small and eccentric nucleoli (40x).
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figure1
A peritoneal washing cytology (PWC) revealed the presence of neoplastic cells (Figure 1).
(A) Baseline CT scan revealed an inhomogeneous hypodense lesion in the head of pancreas; (B) after chemotherapy with gemcitabine plus cisplatin; (C) within 24 hours after HIFU pancreatic lesion shows a lump of necrotic tissue (between thrid and fourth FOLFIRI cycle); (D) CT scan at six weeks after HIFU; (E) 16 weeks after HIFU.
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figure2
Because of the particular histotype, he was not eligible for first-line chemotherapy trials, therefore a regimen with cisplatin (60 mg/mq day 1 every 21) and gemcitabine (1000 mg/mq days 1, 8, every 21) was decided on an individual scale and administered outside clinical trials (Figure 2).