The pathological features of carcinoma of the pancreas

The frequency of cancer of the pancreas is increasing and has surpassed that of cancer of the stomach. Lesions are more common in the head of the gland than in the body and tail. Smaller tumours tend to be localized and are associated with a better prognosis. The majority of tumours are hard and demonstrate a prominent desmoplastic reaction. They present as ill-defined masses which makes their differentiation from chronic pancreatitis difficult. Duct cell adenocarcinomas constitute 75% of all cancers of the pancreas. Some of the uncommon types include giant cell carcinoma, adenosquamous carcinoma, mucinous cystadenocarcinoma and acinar cell carcinoma. The role of open biopsy in diagnosing cancer of the pancreas remains controversial. Percutaneous fine-needle aspiration cytology appears promising. The technique is safe and inexpensive but needs an experienced cytopathologist to interpret the results accurately.