– Adenocarcinoma (see comment)
COMMENT: The aspirate smears are abundantly cellular and show sheets and clusters of malignant appearing cells that are characterized by architectural disarray, nuclear pleomorphism (greater than 4:1), and irregular nuclear contours. The cell block shows similar findings. The features are those of adenocarcinoma and are consistent with a pancreatic primary, however the difference between in situ and invasive carcinoma cannot be determined on cytology specimens. Clinical and radiographic correlation is recommended.
– Well-differentiated neuroendocrine tumor (see comment)
COMMENT: The aspirate smears are abundantly cellular and show a discohesive population of cells with moderate amounts of granular cytoplasm and round nuclei with stippled chromatin. The cell block shows similar findings with nested architecture. These cells stain with immunohistochemical stains for synaptophysin and chromogranin, consistent with neuroendocrine differentiation. Overall, these findings are diagnostic of a well-differentiated neuroendocrine tumor. No necrosis or mitotic activity is identified. These cells have a Ki67 proliferation index of approximately ***% (***/500 cells counted), consistent with a provisional WHO grade of ****. Clinical and radiographic correlation is recommended.
– Suspicious for mucinous neoplasm (see comment)
COMMENT: The aspirate smears are moderately cellular and show sheets of cytologically bland mucinous epithelium in a background of very thick mucin. The radiographic impression of a cystic lesion is noted. Overall, these findings are suspicious for a mucinous neoplasm, such as an intraductal papillary mucinous neoplasm. Clinical and radiographic correlation is recommended.
– Cytologically bland glandular epithelium, favor gastrointestinal contaminant (see comment)
COMMENT: The aspirate smears show predominantly large flat sheets of bland glandular epithelium, some of which contain goblet cells, as well as thin, wispy mucin strands. Rare fragments of pancreatic acinar tissue are seen. There are no features present to suggest biopsy of a cystic lesion. Overall, these features are most consistent with sampling of the gastrointestinal tract as a result of the biopsy procedure. Clinical and radiologic correlation is recommended.
Last updated: Sep 2, 2019