Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 12 December 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.
● Sheets of carcinoma cells with abundant eosinophilic cytoplasm, large vesicular nuclei with prominent nucleoli, often intraepithelial infiltrate of lymphocytes (WHO)
● Very rare tumor associated with microsatellite instability (50%), colonic adenocarcinoma (Hum Pathol 2006;37:1498), family history of cancer at other sites
● Good prognosis
● Soft (since minimal desmoplastic stroma)
● Syncytial growth of poorly differentiated tumor cells accompanied by chronic inflammatory infiltrate, minimal desmoplastic stroma, pushing (expanding) border and extensive necrosis, associated PanIN (Am J Pathol 2000;156:1641, Stanford University)
A-extensive necrosis, B-poorly differentiated tumor with syncytial growth pattern
A-nuclear staining for MLH1; B-loss of expression of MSH2; C-loss of expression of MSH6
● Usually no Kras mutations, but 20% have inactivation of DNA mismatch repair system
End of Pancreas > Tumors > Medullary carcinoma
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