2020 Volume 59 Issue 2 Pages 103-111
Background : Anaplastic carcinoma is a rare tumor and carries a poor prognosis. Herein, we report two cases of anaplastic carcinoma of the pancreas.
Cases : Case 1 : A female patient in her 70 s was detected to have a tumor in the pancreatic head by abdominal ultrasonography performed during a follow-up visit after a cardiac operation.
Case 2 : A female patient in her 70 s was admitted to hospital complaining of abdominal pain. Abdominal computed tomography (CT) revealed a tumor in the pancreatic head.
Endoscopic ultrasound-fine needle aspiration (EUS-FNA) biopsy was performed in both patients.
Cytologically, round and spindle-shaped tumor cells were seen, either scattered, in clusters, or arranged in sheets. Osteoclast-like giant cells were also recognized.
On gross examination, both tumors showed severe hemorrhage and necrosis on cut surface.
Histological examination revealed proliferation of spindle-shaped and polygonal tumor cells with prominent nucleoli and irregular nuclear contour arranged in a disarray or in a solid sheets. Small foci of adenocarcinoma were also seen. Osteoclast-like giant cells were prominent in the hemorrhagic areas. In Case 1, cartilaginous matrix was also seen.
On immunohistochemical examination, the spindle-shaped cells and polygonal cells showed positive staining for vimentin and CAM5.2, while the osteoclast-like giant cells showed positive staining for CD68.
Based on above findings both tumors were diagnosed as anaplastic carcinoma.
Conclusion : Identification of spindle-shaped/round tumor cells and osteoclast-like multinucleated giant cells on pancreatic cytology should suggest the possibility of anaplastic carcinoma in the differential diagnosis.
