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Pigmented solid-pseudopapillary neoplasm of the pancreas
Ondrej Daum1, Radek Sima, Petr Mukensnabl
1Department of Pathology, Medical Faculty Hospital, Pilsen, Czech Republic.
Pathology International
|May 6, 2005
Summary
A rare variant of pancreatic solid-pseudopapillary neoplasm was identified in a 57-year-old female. The tumor contained unique intracellular pigmented granules, identified as lipofuscin, not melanin.
Area of Science:
- Pathology
- Oncology
- Gastroenterology
Background:
- Solid-pseudopapillary neoplasm (SPN) is a rare pancreatic tumor, typically affecting young women.
- This report details a previously unrecognized variant of SPN with distinct histological and ultrastructural features.
Observation:
- A 57-year-old female presented with a 27 mm pancreatic head tumor.
- Histology revealed a solid-pseudopapillary pattern with uniform cells, lacking mitotic activity or invasion.
- Intracellular pigmented granules were observed in specific tumor areas.
Findings:
- Immunohistochemistry showed positivity for vimentin, neuron-specific enolase, and CD56, but negativity for other neuroendocrine and melanocytic markers.
- Special stains and ultrastructural analysis confirmed the pigment as lipofuscin, not melanin.
- The pigment granules contained lipid droplets, resembling modified lysosomes.
Implications:
- This finding expands the spectrum of histological appearances for pancreatic SPN.
- Accurate identification of the pigment is crucial for differential diagnosis, excluding melanogenic tumors.
- Understanding the nature of these granules may offer insights into SPN pathogenesis.