case_images: PMC6247962_01
case_images: CT showed a 40 x 45 mm heterogeneous irregular hypodense mass in the distal body and tail of the pancreas (A), and it was enhanced after infusion of contrast material (B). PET-CT showed diffuse abnormal uptake only in the pancreatic mass (C).. Abbreviation: PET-CT, positron emission tomography-computed tomography.
case_images: ott-11-8197Fig1.jpg
case_images: PMC6247962_01_ott-11-8197Fig1.jpg
case_images: f1-ott-11-8197
case_images: Abdominal computed tomography (CT) showed a 40 x 45 mm heterogeneous irregular hypodense mass in the distal body and tail of the pancreas (Figure 1A), and it was enhanced after infusion of contrast material (Figure 1B). Positron emission tomography-CT showed diffuse abnormal uptake only in the pancreatic mass (Figure 1C).
case_images: Gross photograph showing a firm and grayish white tumor from the spleen and the rest of the pancreas (A). Microscopically, it was predominantly composed of cells with abundant clear cytoplasm and well-defined cell borders (B, C).. Note: Black arrow points to a typical clear neoplastic cell.
case_images: ott-11-8197Fig2.jpg
case_images: PMC6247962_01_ott-11-8197Fig2.jpg
case_images: f2-ott-11-8197
case_images: Distal pancreatectomy and splenectomy were performed, and the specimen was sent for histopathological examination (Figure 2A). Microscopically, highly atypical glands were composed of round or oval bulky cells with abundant clear cytoplasm and well-defined cell borders (Figure 2B and C).
case_images: Immunohistochemically, tumor cells showed positivity for CK-7 (A) and negative for HNF-1beta (B) and CA9 (C).. Abbreviations: CA9, carbonic anhydrase 9; CK-7, cytokeratin-7; HNF-1beta, hepatocyte nuclear factor-1beta.
case_images: ott-11-8197Fig3.jpg
case_images: PMC6247962_01_ott-11-8197Fig3.jpg
case_images: f3-ott-11-8197
case_images: Immunohistochemistry showed strong and diffuse staining for cytokeratin-7 (CK-7) (Figure 3A), and the immunohistochemistry staining was negative for chromogranin A (CGA), synaptophysin (SYN), hepatocyte nuclear factor-1beta (HNF-1beta) (Figure 3B), and carbonic anhydrase 9 (CA9) (Figure 3C).