PMC5376181_01
Abdominal computed tomography findings.. Notes: Computed tomography scan showing a well-demarcated tumor (arrows) in the pancreas head, with heterogeneous enhancement: axial view (A) and intravenous contrast-enhanced axial (B), sagittal (C), and coronal (D) views.
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The mass showed slight hypoattenuation on unenhanced computed tomography (CT), with heterogeneous enhancement on the arterial phase after contrast injection (Figure 1).
Histopathology of the pancreatic tumor.. Notes: Gross pathology showing a yellowish-gray, firm, well-circumscribed tumor (A). Histological findings showing "patternless pattern" arranged spindle tumor cells and thick collagen (B) (original magnification x40), and infiltration of the submucosa of the duodenum (C) (original magnification x40). Immunohistochemical staining demonstrating strong CD34 positivity (D) (original magnification x100).
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The mass appeared grossly well-circumscribed and non-capsulated with yellowish-gray cut surface (Figure 2A). Histological examination revealed the tumor consisted of "patternless pattern" arranged spindle tumor cells and keloid-like hyalinized collagen (Figure 2B). A mild to moderate degree of nuclear pleomorphism and a few atypical mitotic figures (2-5 per 10 high-power fields) were noted in the hypercellular area. The submucosa of the duodenum was microscopically infiltrated (Figure 2C). IHC revealed that the tumor cells were strongly positive for CD34 (Figure 2D) and vimentin, focally positive for SMA, and negative for CD117, CD99, CD56, NSE, ALK, EMA, DES, S-100, MYOG, CEA, SYP, CgA, BCL-2, and CK.