DIAGNOSIS OF ACINAR CELL CARCINOMA USING ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION : A CASE REPORT

Abstract

In February 2010, a 50-year-old man was admitted to a clinic complaining of back pain. Enhanced computed tomography (CT) images showed that there was a unilocular cyst, approximately 40 mm in size, in the pancreatic head of his abdomen. He was diagnosed as having a pancreatic pseudocyst caused by pancreatitis. After treatment, the patient's symptoms disappeared. However, in July 2010, he was referred to our medical center because back pain had reappeared along with obstructive jaundice. CT imaging showed growth of the cystic lesion and a low-density area of newly appeared cysts. The combination of clinical course and image results suggested malignancy, but it was difficult to confirm the diagnosis. Specimens sampled with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) revealed acinar cell carcinoma (ACC). This case showed atypical images for ACC as cystic lesions were dominant. These results are notable in that ACC may reveal atypical findings and that EUS-FNA can be useful in the diagnosis of such cases.