Letný bioptický seminár SD-IAP Letný bioptický seminár SD-IAP Senec 21-22.6.2013 Senec 21-22.6.2013 MUDr. Juraj Marcinek, PhD. MUDr. Juraj Marcinek, PhD. Prípad SD-IAP 480 Prípad SD-IAP 480 Ústav patologickej anatómie a Konzultačné centrum Ústav patologickej anatómie a Konzultačné centrum hematopatológie UNM a JLF UK hematopatológie UNM a JLF UK
Letný bioptický seminár SD-IAP Senec 21-22.6.2013. MUDr. Juraj Marcinek, PhD. Prípad SD-IAP 480. Ústav patologickej anatómie a Konzultačné centrum hematopatológie UNM a JLF UK. - PowerPoint PPT Presentation
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68 yer old man – Ca capitis pancreatis (cT3 N1 MX)68 yer old man – Ca capitis pancreatis (cT3 N1 MX)
makroskopic finding: vhite tumorous mas of 18mm rising aroud pancreatic duct in themakroskopic finding: vhite tumorous mas of 18mm rising aroud pancreatic duct in the
head of pancreashead of pancreas
under duodenal serosa visible tumorous mass corresponding to LNunder duodenal serosa visible tumorous mass corresponding to LN
hepatoid carcinomas – heterogenous neoplasms with morphologic and phenotypic hepatoid carcinomas – heterogenous neoplasms with morphologic and phenotypic
resemblance to hepatocellular carcinoma (HCC)resemblance to hepatocellular carcinoma (HCC)
- most common arise in stomach (since Ishikura et al. 1985)- most common arise in stomach (since Ishikura et al. 1985)
- less common in ovary, testis, esophagus, duodenum, pancreas, - less common in ovary, testis, esophagus, duodenum, pancreas,
differential diagnosis of hepatoid carcinomas from: differential diagnosis of hepatoid carcinomas from:
1. hepatocellular carcinoma with extrahepatic spreading – problematic to impossible1. hepatocellular carcinoma with extrahepatic spreading – problematic to impossible
hepatoid carcinomas - morphologically similar, but often contain variabile amounth hepatoid carcinomas - morphologically similar, but often contain variabile amounth glandular or tubulopapilary adenocarcinomatous componentglandular or tubulopapilary adenocarcinomatous component - immunohistochemical pattern of HCC usually incomplete with - immunohistochemical pattern of HCC usually incomplete with strong coexpression of cytokeratins atypical fo HCC (CK19, strong coexpression of cytokeratins atypical fo HCC (CK19, CK17, CK20)CK17, CK20) - CEAm+ in adenocarcinomatous component- CEAm+ in adenocarcinomatous component - CEAp+ in both components (luminal/canalicular in hepatoid c.)- CEAp+ in both components (luminal/canalicular in hepatoid c.) - most important are clinical informations of liver finding- most important are clinical informations of liver finding - HCC spread into pancreas is a rare (2,7-5,6%) and late finding- HCC spread into pancreas is a rare (2,7-5,6%) and late finding - multiple liver nodules without chronic liver disease associated - multiple liver nodules without chronic liver disease associated with other large large gastrointestinal tumor are prone to be with other large large gastrointestinal tumor are prone to be metastasesmetastases
differential diagnosis of hepatoid carcinoma of pancreasdifferential diagnosis of hepatoid carcinoma of pancreas
3. pancreatoblastoma3. pancreatoblastoma
- mainly in children (1st. decade of live)- mainly in children (1st. decade of live)
- trabecular and solid growth pattern with/without other pancreatic structures- trabecular and solid growth pattern with/without other pancreatic structures