A minute nonfunctioning pancreatic endocrine tumor with ductal structures and prominent fibrous stroma: Report of a case

Naoki Ikenaga, Kazuyoshi Nishihara, Fujio Katsumoto, Hiroaki Matsunaga, Toshihumi Nasu, Yumi Oshiro, Mari Nakamori, Satoshi Toyoshima, Minoru Ono, Shoshu Mitsuyama

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Abstract

A 50-year-woman reporting general fatigue and found in abdominal ultrasonography to have a 1cm tumor in the body of the pancreas was suspected of pancreatic endocrine tumor because of contrast medium enhanced in CT. Abdominal MRI showed a low-intensity mass in the pancreatic body both in T1 and T2-weighted imaging unusual for an endocrine tumor. Serum CA19-9 was markedly elevated at 1,459.2U/ml, necessitating resection because pancreatic ductal carcinoma could not be ruled out. Histologically, the well-circumscribed tumor consisted of nests of endocrine tumor cells embedded in prominent fibrous stroma. The strong fibrosis appeared to cause the low intensity in T2-weighted MRI. The tumor had focally evident ductal structures and close contact with endocrine tumor cells. Immunohistologically, tumor cells were positive for chromogranin A and glucagon, but were negative for insulin, gastrin, and somatostatin. The ductal component was immunoreactive to CA19-9. The tumor was definitively diagnosed as nonfunctioning pancreatic endocrine tumor. Pathological findings in this case support the idea of pancreatic duct epithelia were differentiating into endocrine cells and ductal structures.

Original languageEnglish
Pages (from-to)673-678
Number of pages6
JournalJapanese Journal of Gastroenterological Surgery
Volume38
Issue number6
DOIs
Publication statusPublished - Jan 1 2005

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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    Ikenaga, N., Nishihara, K., Katsumoto, F., Matsunaga, H., Nasu, T., Oshiro, Y., Nakamori, M., Toyoshima, S., Ono, M., & Mitsuyama, S. (2005). A minute nonfunctioning pancreatic endocrine tumor with ductal structures and prominent fibrous stroma: Report of a case. Japanese Journal of Gastroenterological Surgery, 38(6), 673-678. https://doi.org/10.5833/jjgs.38.673