Pancreas
Exocrine carcinomas
Medullary carcinoma
Author: Deepali Jain, M.D.
Topic Completed: 1 August 2012
Minor changes: 23 October 2020
Copyright: 2002-2022, PathologyOutlines.com, Inc.
PubMed Search: Medullary carcinoma pancreas
Table of Contents
Definition / general | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Molecular / cytogenetics descriptionCite this page: Jain D. Medullary carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/pancreasmedullary.html. Accessed January 17th, 2022.
Definition / general
- Sheets of carcinoma cells with abundant eosinophilic cytoplasm, large vesicular nuclei with prominent nucleoli, often intraepithelial infiltrate of lymphocytes (IARC: 8510 / 3 Medullary Carcinoma, NOS [Accessed 15 December 2017])
- Very rare tumor associated with microsatellite instability (50%), colonic adenocarcinoma (Hum Pathol 2006;37:1498), family history of cancer at other sites
- Good prognosis
Gross description
- Soft (since minimal desmoplastic stroma)
Microscopic (histologic) description
- 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: Medullary Carcinoma of the Pancreas [Accessed 15 December 2017])
Microscopic (histologic) images
Images hosted on other servers:
Syncytial growth pattern
Lymphoepithelioma
like features
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
Molecular / cytogenetics description
- Usually no KRAS mutations but 20% have inactivation of DNA mismatch repair system
