Cytopathological and immunocytochemical findings of pancreatic anaplastic carcinoma with ZEB1 expression by means of touch imprint cytology |
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Authors: | Yoshiki Naito MD PhD Akihiko Kawahara CFIAC PhD Tomoki Taira CT Yorihiko Takase CT Kazuya Murata CT PhD Yusuke Ishida MD PhD Yoshinobu Okabe MD PhD Masahiko Tanigawa MD Yutaro Mihara MD Masamichi Nakayama MD PhD Kazuhide Shimamatsu MD PhD Hirohisa Yano MD PhD Jun Akiba MD PhD |
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Affiliation: | 1. Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan;2. Department of Pathology, Kurume University School of Medicine, Kurume, Japan;3. Division of Gastroenterology, Department of Internal Medicine, Kurume University, Kurume, Japan;4. Department of Pathology, Omuta City Hospital, Omuta, Japan |
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Abstract: | Pancreatic anaplastic carcinoma (PAC) is rare and has an aggressive clinical course. We report an autopsy case of PAC focusing on the cytopathological characteristics of the tumor and immunocytochemical staining for vimentin, E‐cadherin, and zinc finger E‐box binding homeobox 1 (ZEB1), which markers are associated with epithelial markers of epithelial‐mesenchymal transition (EMT). A 50‐year‐old woman presented to our hospital with a chief complaint of jaundice. A pancreatic head tumor and multiple liver nodules were detected on abdominal computed tomography. Biliary cytology under endoscopic retrograde cholangiopancreatography suggested ductal adenocarcinoma. Three months after admission, she died of multiorgan failure. At autopsy, touch imprint cytology using squash preparation of the pancreatic tumor identified two different cell types; numerous isolated malignant cells with large and pleomorphic nuclei and a few clusters showing irregularly overlapped nuclei and irregular contours within the necrotic background. Immunocytochemically, isolated cells were positive for vimentin and ZEB1, and negative for E‐cadherin. Conversely, clusters were negative for vimentin and ZEB1, and positive for E‐cadherin. Histologically, the tumor was composed of sarcomatous cells with small foci of adenocarcinoma, which were consistent with a diagnosis of PAC. Immunohistochemical staining of the adenocarcinoma and sarcomatous cells corresponded to those of the clusters and isolated malignant cells, respectively. Immunostaining of these EMT markers is useful to distinguish sarcomatous cells from adenocarcinoma and can contribute to the accurate diagnosis of pancreatic tumors with EMT. |
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Keywords: | autopsy case epithelial‐mesenchymal transition (EMT) pancreas pancreatic anaplastic carcinoma touch imprint cytology (TIC) zinc finger E‐box binding homeobox 1 (ZEB1) |
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