PMC3643362_01
(a) Numerous lymphocytes and plasma cells with necrotic material and fibrosis are visible (Diff-Quik, x400); (b) Atypical epithelial cells (Diff-Quik, x1000); (c) The cut surface of the resected specimen show an elastic, hard, white mass that was located in the pancreas tail; (d) Ductal adenocarcinoma with lymphoplasmacytic infiltration was visible (H and E, x100); (e) Immunohistochemical findings showed abundant IgG4-positive plasma cells around the pancreatic duct and cancer cells (IHC, x100)
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F1
The smear preparations showed numerous lymphocytes including plasma cells with necrotic material [Figure 1a] and small clusters of atypical epithelial cells [Figure 1b]. The cut surface of the resected pancreas showed an elastic, hard, white mass in the pancreas tail [Figure 1c]. Invasive ductal adenocarcinoma with lymphoplasmacytic infiltration was also observed in these lesions [Figure 1d]. Immunohistochemical staining, revealed abundant IgG4-positive plasma cells (>50 cells per high-power field [HPF]) around the pancreatic duct and tumor cells [Figure 1e].