PMC5055922_01
CT image demonstrating presence of a heterogeneous well-demarcated mass arising from the body and tail of the pancreas (marked with a blue arrow) and extending towards the splenic hilum.
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fig1
Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 x 7.6 x 10.3 cm size heterogeneous mass with mild contrast enhancement arising from the body and the tail of the pancreas with no calcifications (Figure 1).
Patient operated on in right lateral position with head-up tilt using ports arranged as in this image.
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fig2
Patient was operated on in right lateral position with head-up tilt using five ports.  Figure 2 shows the ports arrangement.
Macroscopic appearance of distal pancreatectomy with splenectomy specimen containing well-demarcated lobulated mass (red arrow), part of body of pancreas (blue arrow), and spleen (yellow arrow).
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fig3
The specimen (Figure 3) was delivered in a bag through a 7.5 cm incision.
Haematoxylin and eosin stained section showing sheets of polygonal cells displaying bland nuclei and a thin rim of eosinophilic cytoplasm containing sharp vacuolations. Occasional mitotic figures are present (x400).
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fig4
Very occasional mitotic figures were present (Figure 4).
Haematoxylin and eosin stained sections revealing foci of pseudopapillae and rosettes with vascular cores lined by neoplastic cells (x400).
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fig5
The focal pseudopapillae formation was also evident with vascular cores lined by neoplastic cells (Figure 5).
Haematoxylin and eosin stained sections displaying highly vascular and haemorrhagic stroma. Loosely cohesive cellular clusters are seen scattered within the stroma (x400).
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The stroma was highly vascular (Figure 6).
Haematoxylin and eosin stained section showing thin fibrous capsule encircling the tumour (x200).
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fig7
Thin fibrous capsule was noted encircling the tumour (Figure 7).
Haematoxylin and eosin stained section showing focus of partial capsular infiltration by the tumour (x100).
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fig8
Multiple foci of partial capsular infiltration were also noted (Figure 8).