PMC9448957_01
Magnetic resonance imaging showing complete obstruction of the distal bile duct (white arrow).
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F1
Magnetic resonance cholangiography showed complete obstruction of the common bile duct (Figure 1).
(A) Gross specimen of pylorus-preserving pancreaticoduodenectomy, with the white arrow indicating cancer. (B) Histologic findings of the distal common bile duct. (C) Magnified image of the orange closed curve in (B), showing moderately differentiated adenocarcinoma cells of the distal common bile duct.
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F2
A histological evaluation of the background pancreas showed normal pancreas (Figure 2).
Abdominal CT revealed a big lesion (arrowhead) at the remnant pancreas body.
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F3
Abdominal CT revealed a big 2.3 cm lesion at the remnant pancreas body (Figure 3).
(A) Gross specimen of completion total pancreatectomy comprising the remnant pancreas body, spleen, and a jejunal segment including pancreaticojejunostomy, with the white arrow indicating cancer. (B) Histologic findings of the pancreas body including cancer. (C) Magnified image of the black square in (B), showing pancreatic ductal adenocarcinoma cells (black circle) and multiple lesions of low grade to a high degree of pancreatic intraepithelial neoplasia around the main lesion (black right triangle).
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F4
Histologic evaluation revealed moderately differentiated pancreatic ductal adenocarcinoma with perineural and lymphatic invasion; no lymph nodes were found positive for malignant cells; and there were multiple lesions of low grade to a high degree of pancreatic intraepithelial neoplasia (PanIN) around the main lesion, and the tumor stage was T2N0M0, stage IB, based on the TNM classification (Figure 4).