PMC6383168_01
CECT showing the heterogeneously enhancing mass arising from the pancreas.
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Contrast enhanced computed tomography (cect) abdomen showed large lobulated, heterogenously enhancing mass with internal necrosis and calcifications in the left hypochondrium in the region of distal body and tail of pancreas (Fig. 1).
Operative and postoperative image.
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At laparotomy, patient was found to have a bilobed tumor arising from the lesser sac adherent to the pancreas and abutting the stomach, transverse colon, and left adrenal and splenic hilum (Fig. 2).
Specimen with tumour and spleen.
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The histologic changes of MPNST include spindle cells with comma-shaped nuclei, tactoid bodies, nuclear palisading, hyaline bands, and schwannoma-like and curlicue foci (Fig. 3).The tumour showed focal S100 positivity,was strongly positive for ki67, was positive for vimentin (Figs. 4 and 5) and negative for cytokeratin,synaptophysin and all GIST markers(CD 117,DOG 1,PDGF) We re-examined the patient thoroughly and there were no cutaneous markers for neurofibromatosis and examination of the eye was normal.
Hematoxylin and eosin staining.
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PMC6383168_01_gr4.jpg
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The histologic changes of MPNST include spindle cells with comma-shaped nuclei, tactoid bodies, nuclear palisading, hyaline bands, and schwannoma-like and curlicue foci (Fig. 3).The tumour showed focal S100 positivity,was strongly positive for ki67, was positive for vimentin (Figs. 4 and 5) and negative for cytokeratin,synaptophysin and all GIST markers(CD 117,DOG 1,PDGF) We re-examined the patient thoroughly and there were no cutaneous markers for neurofibromatosis and examination of the eye was normal.
S100 staining.
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The histologic changes of MPNST include spindle cells with comma-shaped nuclei, tactoid bodies, nuclear palisading, hyaline bands, and schwannoma-like and curlicue foci (Fig. 3).The tumour showed focal S100 positivity,was strongly positive for ki67, was positive for vimentin (Figs. 4 and 5) and negative for cytokeratin,synaptophysin and all GIST markers(CD 117,DOG 1,PDGF) We re-examined the patient thoroughly and there were no cutaneous markers for neurofibromatosis and examination of the eye was normal.
PET scan.
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Positron emission tomography (Fig. 6) was done which revealed para aortic nodes and 2 mesentric nodes.