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Oncocytic carcinoma of the pancreas.Cancer.
1983 Jan 15;51(2):332-6.
A large firm 12.5
cm mass at the tail of pancreas was surgically resected in a
73-year-old white man. The tumor was composed of solid sheets of cells
with abundant finely granular eosinophilic cytoplasm. Electron
microscopic study revealed tumor cells which were packed with
mitochondria, a feature characteristic of the oncocyte. Perineural
invasion and direct extension into the parenchyma of the spleen was
present, as well as metastasis to a lymph node. There appears not to
be a report of a similar case.
A case of pancreatic
oncocytic tumor.Acta
Pathol Jpn. 1990 ;40(5):367-70.
An uncommon case
of potentially malignant oncocytoma arising in the pancreatic tail of
54-year-old woman is reported. The tumor was encapsulated and measured
11 x 7 x 6 cm. The tumor cells were uniform in appearance, plump and
polyhedral, with distinct finely granular eosinophilic cytoplasm, and
were arranged in solid acinar groups. Electron microscopy revealed
that the tumor cells contained numerous mitochondria in the cytoplasm.
In the present case, the tumor cells showed perineural and small
venous invasion in the pancreas and potentially malignant
characteristics. However, neither recurrence nor metastasis has been
detected 3 years after resection. These findings indicate that the
present tumor had apparent low-grade malignancy.
Papillary cystic
tumor of the pancreas: a case indistinguishable from oncocytic
carcinoma.Pancreas.
1993 Jan;8(1):127-32.
A case of
papillary cystic tumor (PCT) of the pancreas in a 55-year-old woman is
described. She presented with a gradually enlarging and painless
abdominal mass for > 26 years. The tumor was encapsulated and measured
16 x 12 x 10 cm. The gross features and conventional light microscopic
appearance of this tumor were consistent with the previously reported
cases of PCT. Perineural and capsular invasions were found. In
addition to the densely packed blue granules in the cytoplasm
demonstrated by phosphotungstic acid-hematoxylin stain,
ultrastructural study revealed the tumor cells to be packed with
numerous mitochondria. These oncocytes comprised almost all the
non-necrotic tumor areas. Therefore, this case was indistinguishable
pathologically from oncocytic carcinoma of the pancreas. DNA flow
cytometry showed a diploid pattern and low S phase fraction,
indicating that the tumor has a low proliferative activity and a
favorable prognosis.
Intraductal oncocytic papillary neoplasms of the pancreas.Am
J Surg Pathol. 1996 Aug;20(8):980-94.
We describe the
clinical and pathologic features of 11 intraductal oncocytic papillary
neoplasms of the pancreas, a hitherto unrecognized tumor. The patients
were six men and five women, and most of the tumors were in the head
(head: body/tail = 8:3). The mean patient age was 62 (range, 39-78),
and the average tumor size was 6 cm. Grossly the tumors exhibited
mucin-filled cysts containing nodular papillary projections. Dilated
ducts communicating with the main tumor were sometimes noted.
Microscopically the cystic structures appeared to represent dilated
ducts containing intraductal tumor. The tumors were characterized by
variably complex, arborizing papillary structures. The papillae had
thin, delicate fibrovascular cores with focal myxoid changes and were
lined by stratified oncocytic cells. Goblet cells and intra-epithelial
mucin-containing lumina were present, the latter resulting in a
characteristic cribriform pattern. The exuberance of the epithelial
proliferation varied from case to case and between different regions
within individual tumors; solid sheets of cells were often identified.
Although the degree of cytologic atypia was not generally severe, the
complexity of the architecture justified a designation of intraductal
oncocytic papillary carcinoma in 10 of the 11 cases. In nine cases the
tumor was entirely intraductal; one case exhibited focal microinvasion
and another showed widespread invasive carcinoma, the invasive
elements appearing cytologically similar to the intraductal papillary
components. The oncocytic cells stained positively with
phosphotungstic acid hematoxylin and Novelli stains.
Immunohistochemically, all cases stained positively for B72.3, and
five cases showed focal, weak luminal membrane staining for
carcinoembryonic antigen. Ultrastructurally many of the cells were
packed with mitochondria, and mucin was also identified. Seven
patients were alive and free of tumor from 1 month to 3 years
(average, 1 year) after resection. Two patients died postoperatively.
The remaining two patients died with no evidence of disease at 2.5 and
5 years, the latter following a recurrence at 2.5 years. We conclude
that intraductal oncocytic papillary neoplasm is a distinctive
pancreatic tumor that is usually intraductal but may develop invasive
carcinoma and should be treated with complete resection.
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