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Virchows Archiv

, Volume 467, Issue 2, pp 237–245 | Cite as

Hepatoid carcinoma of the pancreas with lymphoid stroma: first description of the clinical, morphological, immunohistochemical, and molecular characteristics of an unusual pancreatic carcinoma

  • Alessandro VanoliEmail author
  • Francesca Argenti
  • Alessio Vinci
  • Stefano La Rosa
  • Alessandra Viglio
  • Roberta Riboni
  • Vittorio Necchi
  • Luigi Pugliese
  • Fausto Sessa
  • Andrea Pietrabissa
  • Marco Paulli
Case Report

Abstract

We report a case of tumour in the head of the pancreas observed in a 57-year-old man with a history of worsening jaundice and elevated alpha-fetoprotein (AFP) serum level, who underwent Whipple pancreatoduodenectomy. Histologically, the tumour was predominantly composed of solid sheets of large eosinophilic cells with a prominent lymphoid infiltration without association neither with DNA microsatellite instability nor Epstein-Barr virus infection. The tumour was diffusely and strongly positive for hepatocyte paraffin-1 (Hep Par-1) and glypican-3 leading to the diagnosis of hepatoid carcinoma. Strong cytoplasmic staining for AFP was focally observed. Moreover, tumour cells showed countless cytoplasmic eosinophilic globules immunoreactive for the stress protein p62. A primary hepatocellular carcinoma of the liver was ruled out by careful clinical analysis. Hepatoid carcinoma is an extremely rare pancreatic neoplasm, and here, we describe the first case of such variant associated with lymphoid stroma. The characteristic histologic features and the immunophenotypic profile help in distinguishing this carcinoma from other pancreatic tumours, notably from medullary carcinoma.

Keywords

Hepatoid carcinoma Lymphoid stroma Medullary carcinoma Pancreas 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Alessandro Vanoli
    • 1
    • 3
    Email author
  • Francesca Argenti
    • 2
  • Alessio Vinci
    • 2
  • Stefano La Rosa
    • 4
  • Alessandra Viglio
    • 1
  • Roberta Riboni
    • 1
  • Vittorio Necchi
    • 1
  • Luigi Pugliese
    • 2
  • Fausto Sessa
    • 3
    • 4
  • Andrea Pietrabissa
    • 2
  • Marco Paulli
    • 1
  1. 1.Department of Pathology, Fondazione IRCCS Policlinico San Matteo, and Department of Molecular MedicineUniversity of PaviaPaviaItaly
  2. 2.Division of General Surgery 2, Fondazione IRCCS Policlinico San MatteoUniversity of PaviaPaviaItaly
  3. 3.Department of Surgical and Morphological SciencesUniversity of InsubriaVareseItaly
  4. 4.Department of PathologyOspedale di CircoloVareseItaly

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