Pancreas
Exocrine tumors / carcinomas
Undifferentiated carcinoma


Topic Completed: 1 August 2012

Revised: 29 January 2019

Copyright: (c) 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Undifferentiated carcinoma[TI] pancreas

Deepali Jain, M.D.
Page views in 2018: 1,284
Page views in 2019 to date: 1,233
Cite this page: Jain D. Undifferentiated carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pancreasundifferentiated.html. Accessed October 19th, 2019.
Definition / general
Clinical features
  • Usually elderly patients, who present with widely disseminated disease
  • Very poor prognosis
Case reports
Gross images

AFIP

Whipple resection specimen shows ill demarcated tumor in head of pancreas with large areas of central necrosis (yellow)

Tumor mass in tail
with extensive
hemorrhagic
necrosis

Microscopic (histologic) description
  • High grade carcinoma with no evidence of glandular, squamous or urothelial differentiation
  • May have discohesive, bizarre, multinucleated giant cells (not osteoclast-like) and resemble giant cell carcinoma of lung, adrenal, liver
  • Dense inflammatory infiltrate with emperipolesis (neutrophils in tumor cells)
Microscopic (histologic) images

AFIP

Spindle cell sarcomatoid features

Poorly cohesive sarcomatoid pattern of pleomorphic large cells with single or multiple nuclei, supported by scanty fibrous stroma

Tumor cells show occasional engulfment of red blood cells or other tumor cells (cannibalism)


Focus of glandular
differentiation within
a sarcomatoid pattern

Tumor is keratin+

Tumor is CEA+ in
glandular portions
but pleomorphic
cells are negative



Images hosted on other servers:

Poorly cohesive sarcomatoid pattern of pleomorphic large cells with single or multiple nuclei, supported by scanty fibrous stroma

Carcinosarcoma: glandular component is keratin+

Carcinosarcoma: sarcomatous component is vimentin+

Positive stains
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