HISTOPATHOLOGY INDIA.COM

 Atypical Fibroxanthoma

                        Dr Sampurna Roy MD

 
 

                 

An approach to reporting of pancreatic specimen ; Reporting of pancreatic biopsies for the diagnosis of neoplastic lesions ; Reporting of Pancreatico-duodenectomy (Whipple's operation) specimen ; Reporting of Distal Pancreatectomy Specimen.

These biopsy specimens are almost invariably taken at ERCP.

Assessment can be particularly difficult because of the small size of the specimen, poor orientation and crush artifact.

In patients with familial adenomatous polyposis, periampullary adenomas are very common and may carpet the second and third parts of the duodenum.

In these patients, hyperplasia, adenoma and carcinoma may coexist.

Malignant tumours of the periampullary area occur less frequently than in the pancreas, except in patients with familial adenomatous polyposis.

They are nonetheless important as they have a better prognosis than carcinoma of the pancreas.

Neoplasia can arise in the terminal bile duct, the duodenal mucosa, the ampulla itself, and very rarely in Brunner's glands.

Adenocarcinomas in this area are usually intestinal in type rather than more desmoplastic and infiltrative type which occur in the pancreas.

                     

Microscopical report

The report should comment on the presence of:

- Adenoma:

        - Type: villous, tubular, tubulovillous ;

        - Degree of dysplasia ;

        - Focal mucosal or submucosal invasion.

- Malignant neoplasm ;

          - Type: carcinoma, lymphoma, sarcoma;

          - Grades ;

          - Spread: perineural or intravascular.

                       

Anatomy of Normal Pancreas ;   Normal Islets of Langerhans ;   The Apud Concept ;   Developmental Defects of Pancreas ;   Nesidioblastosis ; Pancreas Divisum ;   Aberrant (Ectopic) or Accessory Pancreas  ;   Annular Pancreas  ;   Pancreatic Agenesis ;   Non-Neoplastic Pancreatic Cysts including Congenital and Pseudocysts ;   Pancreatitis ;   Acute Pancreatitis ; Chronic Pancreatitis ;   Autoimmune Pancreatitis ;   Herpes Simplex Pancreatitis ;   Diabetes Mellitus ;   Neoplasms of the Endocrine Tumours ; Islet Cell Tumours ;   Alpha Cell Tumours (Glucagonomas) ;   Beta Cell Tumours (Insulinomas) ;   Somatostatinoma ; VIPomas ;   Pancreatic Polypeptide-Secreting Tumours   ;   Enterochromaffin Cell (Carcinoid) Tumours ; Pancreatic Gastrinoma ;   Corticotropinoma (Ectopic ACTH syndrome) ;   Parathyrinoma ;   Multiple Endocrine Neoplasia (MEN) Syndrome Carcinoma of the Pancreas;
 
September 2009

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