PMC5603138_01
Abdominal computed tomography imaging demonstrating a 27 mm mass in the tail of the pancreas (yellow arrow).
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During a routine follow-up assessment by the urology department, a CT scan revealed a slightly low-density mass (27 mm in diameter) in the tail of the pancreas, with no tumor lesions in other organs (Figure 1).
Magnetic resonance imaging sections of pancreas tumors. Pancreatic tumors were shown as slightly high-intensity regions on T1-weighted imaging and as isointense regions on T2-weighted imaging (yellow arrow: (a), (b)). Diffusion-weighted imaging (DWI) revealed these masses as high-intensity regions (yellow arrow, (c)), and magnetic resonance cholangiopancreatography (MRCP) showed no stenosis and irregularity in the biliary duct and pancreatic duct (d).
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These MRI imaging scans are summarized in Figure 2.
Endoscopic ultrasonography (EUS) imaging sections of pancreas tumors. Pancreatic tumors are shown by Convex EUS. A tumor in the head of the pancreas is shown as yellow arrows in (a) and (b) and that in the tail of the pancreas is shown as yellow arrows in (c) and (d). Both tumors had similar findings and hypervascularity in tumor was demonstrated by Doppler mode of EUS.
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Findings of EUS are shown in Figure 3.
Pathological findings of pancreatic tumor obtained by EUS-FNA and surgical resection. Tumor tissues were obtained from a tumor of the tail of the pancreas. Tumor tissue comprised a cluster of mild atypical cells with clear cytoplasm on hematoxylin and eosin staining (a). IHC stain of tumor tissue obtained by EUS-FNA showed that CD10 (b) and NSE (c) were positive and synaptophysin (d), MUC6 (e), and cytokeratin 7 (f) were negative. PAX-8 (g) and vimentin (h) were positive in tumor tissue obtained by surgical resection.
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Tissue smear slides are shown in Figure 4; tumor tissue comprised a cluster of atypical cells with a clear cytoplasm on hematoxylin and eosin (HE) staining, and clear cell RCC was strongly suspected. Immunohistochemistry (IHC) was positive for CD10 and NSE and negative for cytokeratin 7, synaptophysin, and MUC6 (Figure 4). PAX-8 and vimentin were positive in tumor tissues obtained through surgical resection (Figure 4).