Pancreas - Large duct pattern

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Pancreas

Tumors

Large duct pattern

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 6 December 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Pattern seen in <10% of usual ductal adenocarcinoma; similar or slightly better prognosis (Mod Pathol 2012;25:439)
● Ducts are clustered with irregular jagged contours, may have desmoplastic and myxoid stroma, intraluminal neutrophils and granular debris; usually no cystic change
● Focal microcystic appearance may be due to marked ectasia of infiltrating neoplastic glands, particularly near duodenal muscularis propria
● May have papillary pattern (Am J Surg Pathol 2012;36:696)
● Compared to usual ductal adenocarcinoma: higher % female, higher % in tail

Gross description
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● White, sclerotic mass with numerous microcysts <1 cm, not detectable radiologically

Gross images
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Microcystic pattern

Micro images
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Microcystic well-differentiated neoplastic duct structures

Various images

Differential diagnosis
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● IPMN
● IOPN
● Mucinous cystic neoplasm
● PanIN

End of Pancreas > Tumors > Large duct pattern

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