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- W2041499479 abstract "Invasive pancreatic ductal (pancreatobiliary, ordinary ductal, tubular, scirrhous) adenocarcinoma (DA) is by far the most common tumor of the pancreas and thus is sometimes considered synonymous with “pancreas cancer.” In addition to its classical pattern (characterized by well-defined tubules lined by cuboidal cells), DA sometimes exhibits other morphologic patterns: in some cases, instead of medium size tubules, DA may form large ductal units (microcystic, large duct-type adenocarcinoma) mimicking intraductal neoplasia. Sometimes, the glands form a cribriform/vacuolated pattern in which the vacuoles are large and the nuclei compressed at the periphery of the cell, imparting to the cell an adipocyte-like appearance. DA also may grow in nests, or as individual cells forming indian files, simulating mammary lobular carcinoma. Poorly differentiated forms of DA (pleomorphic, anaplastic) may grow in sheets and may display a hepatoid pattern. The case presented here is an example of a relatively more common and morphologically distinctive variant of DA, the foamy gland pattern, which is deceptively benign appearing and prone to be misdiagnosed as a benign process. In fact, this patient had undergone surgery before this pattern was fully recognized, and the frozen section of the tumor was reported as negative. In this variant, infiltrative glands are well formed and lined by columnar cells that have abundant, pale cytoplasm. The nuclei often are well polarized to the base but wrinkled. The most characteristic features that help distinguish foamy gland patterns from benign mucinous ducts are (1) foamy/microvesicular, pale cytoplasm in which the vesicles are small, fine and evenly sized; and (2) a chromophilic condensation in the apical edge of the cytoplasm that forms a thin, well-delineated band reminiscent of a brush border (brush border-like zone or BLZ). Although the BLZ is strongly positive with mucin markers, the microvesicular component of the cytoplasm is negative (in contrast with the benign mucinous ducts, which often are PAS+). In addition, p53 often is overexpressed in the nuclei of these malignant glands. Recognition of these morphologic variants of DA is important to avoid misdiagnosis, especially in small specimens, and also is important for the differential diagnosis of metastatic tumors." @default.
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- W2041499479 date "2001-05-01" @default.
- W2041499479 modified "2023-09-25" @default.
- W2041499479 title "Pancreatic Ductal Adenocarcinoma With Foamy Gland Pattern" @default.
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- W2041499479 doi "https://doi.org/10.1097/00132583-200105000-00005" @default.
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