Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: Report of a case with osteochondroid differentiation |
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Authors: | Marosh Manduch David F. Dexter Diederick W. Jalink Stephen J. Vanner David J. Hurlbut |
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Affiliation: | 1. Department of Pathology and Molecular Medicine, Queen''s University and Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, Canada K7L 2V7;2. Division of General Surgery, Queen''s University and Kingston General Hospital, in Kingston, Ontario, Canada;3. Division of Gastroenterology, Queen''s University and Kingston General Hospital, in Kingston, Ontario, Canada |
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Abstract: | We report a case of an undifferentiated pancreatic carcinoma with osteoclast-like giant cells with focal osteochondroid differentiation in a 66-year-old man, who presented with painless jaundice, pruritis, and weight loss. Imaging studies revealed an inhomogeneous mass in the head of the pancreas. A pylorus preserving pancreaticoduodenectomy was performed. The resection specimen revealed a 9.5×4.2×3.2 cm3 solid neoplasm in the pancreatic head with direct extension into duodenum and common bile duct. Microscopy showed a cellular neoplasm composed of pleomorphic mononuclear cells (pancytokeratin, and EMA-positive; LCA, and CD68 negative) and osteoclast-like multinucleated giant cells (vimentin, LCA, and CD68-positive; pancytokeratin, and EMA-negative) consistent with OGTP. The tumor contained a focal area of osteochondroid differentiation. Evidence supports that the tumor giant cells are non-neoplastic and of histiocytic origin. Osteochondroid differentiation within undifferentiated carcinoma is unusual; its presence might suggest a sarcoma diagnosis on biopsy material. |
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Keywords: | Undifferentiated carcinoma Osteoclast-like giant cells Pancreas Osteochondroid differentiation |
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