Virtual Slidebox
Presented by the MGH Pathology Service

48 yo M with jaundice. Whipple

MICROSCOPIC FEATURES

• Unilocular or multilocular cystic mass with intraductal papillary growth
• Complex, arborizing papillary architecture
• Papillae have delicate fibrovascular cores with focal myxoid changes
• Epithelium is stratified and made up of oncocytic cells, with bland round nuclei and abundant eosinophilic granular cytoplasm
• Goblet cells are present
• Intraepithelial mucin-containing lumina are present, and impart a cribriform appearance
• Variable atypia, but usually mild

Read more on Intraductal papillary mucinous neoplasm, oncocytic type…

69 M pancreatic mass, duodenal nodules

74 M pancreatic mass, duodenal erosion

CMV inclusions in Brunner’s glands

Middle aged lady with a mass in the groove region. ? Groove pancreatitis, or pancreatic or duodenal cancer?

Female in her 60’s with a pancreatic mass. Whipple specimen.

70 F pancreatic mass

55 year old alcoholic/smoker with chronic pancreatitis and question of pancreatic head mass.

70 yo M with pancreatic tumor. Whipple

MICROSCOPIC FEATURES

• Solid areas composed of monomorphic cells with eosinophilic cytoplasm and bland, sometimes grooved nuclei
• Abundant delicate vasculature
• Can exhibit prominent cystic change with necrosis and hemorrhage, leading to “pseudopapillae” (tumor nodules falling apart, with rim of viable tumor cells left attached to vasculature)
• Contains foam cells, hemosiderin-laden macrophages, and cholesterol clefts
• Tumor cells may have intracytoplasmic hyaline globules
• Infiltrative border despite gross appearance as well-demarcated

Read more on Solid pseudopapillary tumor, predominantly solid…

MICROSCOPIC FEATURES

• Solid areas composed of monomorphic cells with eosinophilic cytoplasm and bland, sometimes grooved nuclei
• Abundant delicate vasculature
• Can exhibit prominent cystic change with necrosis and hemorrhage, leading to “pseudopapillae” (tumor nodules falling apart, with rim of viable tumor cells left attached to vasculature)
• Contains foam cells, hemosiderin-laden macrophages, and cholesterol clefts
• Tumor cells may have intracytoplasmic hyaline globules
• Infiltrative border despite gross appearance as well-demarcated

Read more on Solid-pseudopapillary tumor, predominantly necrotic…