PMC3861608_01
(A) Intact speciman consisting of the pancreatic body and tail with the attached spleen and portion of stomach. The tumor nodule is indicated by the arrow. (B) Spindle cell component of the tumor with background myxoid matrix (H&E; magnification, x10). (C) Scattered malignant epithelial cells merged imperceptibly with the cytologically atypical spindle cells. A scant cytoplasm and no distinct features of specific mesenchymal differentiation were identified. (H&E; magnification, x40) (D) Keratin staining (MNF1) was positive in the glandular and spindle cell elements of the tumor (magnification, x10).
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The surgical specimen consisted of the pancreatic body and tail with the attached spleen and a portion of the stomach (Fig. 1A). The tumor mass was adherent to the serosa of the stomach, adjacent to the splenic artery and vein and externally compressed and obstructed the main pancreatic duct (Fig. 1A). Ill-defined, highly cellular nodules of cytologically atypical spindle cells, intermingling with scattered adenocarcinomatous elements within a myxoid stroma were determined by scanning light microscopy (Fig. 1B). However, no microscopic features indicating specific mesenchymal differentiation were identified (Fig. 1C). The immunohistochemical results are presented in Table I and indicate that the epithelial and spindle tumor cells diffusely expressed pan-cytokeratin MNF-116 (Fig. 1D), cytokeratin 8/18 and nuclear p53, but not nuclear beta-catenin, calponin, CD10 or p63.