case_images: PMC10494914_01
case_images: (A) White-light endoscopy showed a slightly elevated lesion more than 10mm, with irregular surface structure and a demarcation line. (B) Magnify narrow-band imaging (NBI) endoscopy showed that the lesion was classified as capillary patterns (CP) type IIIB according to the NBI CP classification.
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case_images: Magnified NBI endoscopy revealed an irregular mass in the sigmoid colon with sluggish peristalsis (Figure 1), and the microvascular architecture (capillary pattern) of this lesion was of IIIB type, which is observed in deep submucosal invasive carcinomas.
case_images: (A) Contrast-enhanced CT showed a mass, 69*72mm in the tail of pancreas (White arrow). (B) Contrast-enhanced CT showed the thickening of the sigmoid colon (White arrow). (C) 18-FDG PET-scan showed a pancreatic metabolic lesion compatible with neoplastic mass.
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case_images: Moreover, abdominal computed tomography (CT) showed a soft tissue mass (6.9*7.2cm) at the tail of pancreas (Figure 2). In addition, CT results also showed thickening of the sigmoid colon and several masses in the liver and rectovesical pouch (Figure 2). Glands of typical colorectal morphology were not identified. 18-FDG PET-scan showed pancreatic neoplastic mass (6.2*7.2cm) with an obvious uptake of 18-FDG (SUVmax, 10.3) and a suspected secondary lesion in liver (SUVmax, 7.9) and rectovesical pouch (SUVmax, 5.8) (Figure 2).
case_images: (A) Low power and (B) higher power image of hematoxylin and eosin stains showed the atypical glands in the mucosal muscularis of the sigmoid colon. (C and D) Immunohistochemical stains of the adenocarcinoma of the sigmoid colon showed strong positivity in CK7 (C) and negative in CK20 (D).
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case_images: Furthermore, immunohistochemical stain was performed on the colonic lesion (Figure 3) and pancreatic lesion (Figure 4), which showed that these two lesions were strongly and diffusely positive for cytokeratin 7, was negative for cytokeratin 20.
case_images: (A) Low power and (B) higher power image of hematoxylin and eosin stains of the pancreatic mass showed atypical glands with a cribriform pattern. (C) Cytokeratin 7 expression within the glandular component was positive. (D) Cytokeratin 20 expression was negative within the glands.
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case_images: Furthermore, immunohistochemical stain was performed on the colonic lesion (Figure 3) and pancreatic lesion (Figure 4), which showed that these two lesions were strongly and diffusely positive for cytokeratin 7, was negative for cytokeratin 20.