case_images: PMC10716199_01
case_images: (A) CT abdominal imaging of pancreatic mass at time of diagnosis. A heterogeneous hypodense mass at anterior pancreatic head measuring 3.8 cm x 1.9 cm with associated pancreatic ductal obstruction. (B) CT abdominal imaging of lymphadenopathy at time of diagnosis. Lymph node posterior to the uncinate process measuring 10 mm on axial imaging. (C) CT abdominal imaging of pancreatic mass after five cycles of chemotherapy. Pancreatic mass with interval decrease in size to 2.1 cm x 1.0 cm. (D) CT abdominal imaging of lymphadenopathy after five cycles of chemotherapy. Interval decrease in size of lymph node posterior to the uncinate process measuring 3.7 mm on axial imaging. Created with .
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case_images: PMC10716199_01_fonc-13-1240405-g002.jpg
case_images: f2
case_images: The lungs were without metastatic foci ( Figures 2A, B ). After the fifth cycle of chemotherapy, we performed a response evaluation CT of the chest, abdomen, and pelvis, which demonstrated a decreased pancreatic head mass size (2.1 cm x 1.0 cm), decreased lymph node size, and no new lymphadenopathy or metastatic disease ( Figures 2C, D ).
case_images: Malignant cells are positive for Cytokeratin 7, Cytokeratin 5/6, Epithelial Specific Antigen 4 (Ber-EP4) (B, D, E), consistent with carcinomatous origin. The cells are also positive for p63, a squamous cell marker, mucicarmine, an adenocarcinoma marker, consistent with poorly differentiated carcinoma with squamous and glandular differentiations (A, C, F). All images were obtained with a magnification of x400. Created with .
case_images: fonc-13-1240405-g003.jpg
case_images: PMC10716199_01_fonc-13-1240405-g003.jpg
case_images: f3
case_images: The EUS-guided fine needle aspiration (FNA) demonstrated poorly differentiated malignant cells with both squamous and glandular differentiation ( Figure 3 ).