PMC6319694_01
MRI of the abdomen of the 53-year-old woman 1 month before surgery reveals a cystic mass in the head of the pancreas (arrow) with distal pancreatic atrophy. Periportal and peripancreatic lymphadenopathy is appreciated.
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Additional findings included several nonenhancing subcentimeter cystic lesions in the body of the pancreas, atrophy of the tail, and periportal adenopathy with nodes measuring up to 3.5 x 1.9 x 4.8 cm (Fig. 1).
Top left: A focus of acinar cystadenoma superiorly abutting a focus of IPMN. Hematoxylin and eosin stain (100 mum); top right: IPMN with focal high-grade dysplasia. Papillae growing into the ducts:classic of IPMN histology (200 mum); bottom left: granular red cytoplasm showing acinar differentiation and a single prominent nucleus (a feature of acinar cells) (20 mum); bottom right: chymotrypsin stain clearly showing brown appearing zymogen granules from acinar cells (20 mum). IPMN, intraductal papillary mucinous neoplasm.
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There was no evidence of dysplasia within the acinar epithelium (Fig. 2).