case_images: PMC6020517_01
case_images: (a) Diffuse infiltration of the connective tissue by neoplastic cells with hyperchromatic nuclei, inconspicuous nucleoli, and abundant eosinophilic cytoplasm (hematoxylin-eosin, original magnifications: x200). (b) Neoplastic cells are strongly positive for CK7 (immunohistochemistry, original magnifications: x200).
case_images: CRIPA2018-1784548.001.jpg
case_images: PMC6020517_01_CRIPA2018-1784548.001.jpg
case_images: fig1
case_images: The microscopic evaluation showed diffuse infiltration of the connective tissue by malignant cells with hyperchromatic nuclei, inconspicuous nucleoli, and abundant eosinophilic cytoplasm (Figure 1(a)). By immunohistochemistry, the neoplastic cells were strongly positive for pancytokeratin and CK7 (Figure 1(b)) and negative for CK20, CDX2, TTF-1 and PSA.
case_images: (a) Computed tomography scan with intravenous contrast, which showed 5.0 x 2.7 cm irregular, ill-defined, and hypoattenuating mass located in the pancreatic tail and body (labelled as thin arrow). (b) The prior noncontrast computed tomography scan four months earlier showed no lesions in the pancreas and abdomen.
case_images: CRIPA2018-1784548.002.jpg
case_images: PMC6020517_01_CRIPA2018-1784548.002.jpg
case_images: fig2
case_images: The patient underwent a subsequent computed tomography scan with intravenous contrast, which showed a 5.0 x 2.7 cm ill-defined and hypoattenuating mass located in the pancreatic tail and body (Figure 2(a)), with peripancreatic fat infiltration and vascular involvement of splenic artery and vein. The patient had a prior noncontrast computed tomography scan four months earlier, which showed umbilical hernia with fat and no other lesions in the pancreas and abdomen (Figure 2(b)).