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Pancreas

Exocrine tumors

Microglandular carcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 5 December 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● <20 cases, usually elderly men
● Aggressive behavior (Am J Clin Pathol 1996;105:727)
● May be best considered a growth pattern with an aggressive clinical course, not a distinct entity (Am J Surg Pathol 1996;20:1385)

Case reports
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● 77 year old man with mass of pancreatic head (JOP 2012;13:626)

Micro description
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● Neuroendrocrine features by morphology, but not by immunohistochemistry
● Small uniform cells in sheets mixed with small microglandular / cribriform structures without intervening stroma
● Scant cytoplasm, small nucleoli

Positive stains
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● CAM5.2

Negative stains
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● Chromogranin, synaptophysin, NSE, peptide hormones

Electron microscopy description
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● Abortive glandular lumens lined by imperfectly formed microvilli, well-developed junctional complexes
● No dense core secretory granules or zymogen granules

Molecular description
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● In some cases, lack the genetic abnormalities of usual type ductal adenocarcinoma (Eur J Gastroenterol Hepatol 2009;21:1373)

Differential diagnosis
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● Pancreatic endocrine tumors (primary, metastatic): evidence of neuroendocrine differentiation by immunohistochemistry
● Ductal adenocarcinoma of usual type: irregular glands, desmoplasia, mutations of Kras, p53, beta-catenin

End of Pancreas > Exocrine tumors > Microglandular carcinoma

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