case_images: PMC2823681_01
case_images: MRCP showing pancreatic cyst in the head of the organ with dilation of the main and branch pancreatic ducts as well as of the extra- intra hepatic biliary tree.
case_images: 1746-1596-5-4-1.jpg
case_images: PMC2823681_01_1746-1596-5-4-1.jpg
case_images: F1
case_images: In parallel with the dilatation of the main pancreatic duct along its entire course, a significant dilatation of secondary ducts (side-branches) was also documented (Figure 1).
case_images: IPMN in orthotopic pancreas. a. Well-developed papillary projections within the duct. There is architectural and nuclear atypia. (H+E x200), b. Budding off of clusters of neoplastic cells into the lumen (H+E x400).
case_images: 1746-1596-5-4-2.jpg
case_images: PMC2823681_01_1746-1596-5-4-2.jpg
case_images: F2
case_images: Histologic examination of the orthotopic pancreas revealed a non-invasive intraductal papillary mucinous neoplasm involving the main pancreatic duct, with prominent intraductal papillary projections (Figure 2a). There was budding off of clusters of neoplastic cells into the lumen, as well as, significant nuclear pleomorphism with loss of polarity and prominent nucleoli (IPMN with high grade dysplasia; figure 2b).
case_images: a. Ectopic pancreatic tissue within the gastric wall (H+E x100), b. and c. Cystically dilated ducts containing intraluminal papillae. The papillary structures are lined by mucinous epithelium with nuclear atypia, consistent with IPMN (H+E x400).
case_images: 1746-1596-5-4-3.jpg
case_images: PMC2823681_01_1746-1596-5-4-3.jpg
case_images: F3
case_images: Histological examination demonstrated heterotopic pancreatic tissue consisting of well-formed lobules of pancreatic acini and cystically dilated ducts containing intraluminal papillae (Figure 3a, b). The papillary structures were lined by mucinous epithelium with focal intestinal metaplasia and mild to moderate nuclear atypia (Figure 3b, c).