case_images: PMC10846500_01
case_images: CT of abdomen and pelvis with IV contrast. A 101 x 69 mm mixed attenuation mass involving the head of pancreas (green arrow) is shown. Pancreatic duct dilation is not seen. Fatty infiltration of the liver with 41.8 x 63 mm mixed attenuation mass in the right hepatic lobe (yellow arrow) is shown. Right renal parenchymal cyst is shown. CT: computed tomography.
case_images: jmc-15-001-g001.jpg
case_images: PMC10846500_01_jmc-15-001-g001.jpg
case_images: F1
case_images: To further delineate the mass, a computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast was done and showed a 101 mm pancreatic head mass consistent with a neoplastic disease, intra- and extrahepatic biliary dilatation was seen and there was a 41.8 mm mixed attenuation mass in lateral right hepatic lobe, suggesting metastatic neoplastic disease (Fig. 1).
case_images: An oval mass measuring 100 x 80 mm in the head of pancreas seen on endoscopic ultrasound (blue arrow).
case_images: jmc-15-001-g002.jpg
case_images: PMC10846500_01_jmc-15-001-g002.jpg
case_images: F2
case_images: There was an oval mass in the head of pancreas which measured 100 x 80 mm in diameter (Fig. 2).
case_images: Hematoxylin and eosin stain of lymph node specimen showing small and large nests of neoplastic cells with large amount of cytoplasm, prominent nucleoli and intranuclear inclusions (thin black arrows). Few areas of tumor necrosis are seen.
case_images: jmc-15-001-g003.jpg
case_images: PMC10846500_01_jmc-15-001-g003.jpg
case_images: F3
case_images: The neoplastic cells were strongly positive for Cam 5.2, Hep Par-1, arginase-1, glypican-3, villin, beta-catenin and SMAD-4 (Figs. 3-5).
case_images: Pancreatic FNA specimen showing tumor cells staining positive for Hep Par-1 on immunohistochemical stain (thin blue arrow). FNA: fine-needle aspiration.
case_images: jmc-15-001-g004.jpg
case_images: PMC10846500_01_jmc-15-001-g004.jpg
case_images: F4
case_images: The neoplastic cells were strongly positive for Cam 5.2, Hep Par-1, arginase-1, glypican-3, villin, beta-catenin and SMAD-4 (Figs. 3-5).
case_images: Pancreatic FNA specimen showing tumor cells staining positive for arignase-1 on immunohistochemical stain (thin black arrow). FNA: fine-needle aspiration.
case_images: jmc-15-001-g005.jpg
case_images: PMC10846500_01_jmc-15-001-g005.jpg
case_images: F5
case_images: The neoplastic cells were strongly positive for Cam 5.2, Hep Par-1, arginase-1, glypican-3, villin, beta-catenin and SMAD-4 (Figs. 3-5).