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Exocrine tumors

Vacuolated adenocarcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 26 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.


● Infiltrating nests of tumor cells with large vacuoles and "signet-ring" like appearance imparting a pattern resembling adipocytes (Virchows Arch 2010;457:643)
● Not a WHO diagnosis

Clinical features

● Similar clinical features as ductal adenocarcinoma of usual type, except stronger association with smoking

Micro description

● High grade tumors with gland-in-gland arrangement
● Tumor cells form cribriform nests with multiple large vacuoles or microcysts containing cellular debris and mucin
● May resemble fat necrosis
● Have necrotic material in lumen
Note: this pattern is rare in non-pancreatic adenocarcinomas, may be helpful in determining site of origin of metastases

Micro images

Various images

Differential diagnosis

● Adenomatoid tumor
● Breast or prostate cancer, metastatic-treated
● Lipogranuloma
● Mesonephric adenoma
Pancreatic adenocarcinoma, signet ring type: resembles mammary lobular carcinoma with targetoid pattern, signet ring cells, linear infiltration

End of Pancreas > Exocrine tumors > Vacuolated adenocarcinoma

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