Neoplasms

Fig. 1

Acinar Cell Carcinoma (a–c) Surgical specimen (pancreaticoduodenectomy): voluminous tumor (a) with multinodular aspect involving extensively the head of the pancreas and dislocating the common bile duct (C in a); foci of necrosis are present (asterisk in a). Histopathology: the tumor is mostly characterized by polarized cells resembling acinar cells (b). Immunohistochemical staining for trypsin (c)

Fig. 2

Pancreatoblastoma (a–c) Surgical specimen (pancreaticoduodenectomy): voluminous solid mass (a) with clear-cut margins involving extensively the head of the pancreas with central hemorrhagic area. At histopathology (b), prominent acinar differentiation and characteristic squamoid corpuscles (asterisks in c) are seen

Fig. 3

Hepatoid carcinoma (a–d) Surgical specimen (pancreaticoduodenectomy): voluminous solid-lobulated mass (a). Immunohistochemical staining (b) for hepatocyte paraffin-1 antibody. Neoplasm with solid-nested trabecular architecture (c); in this case bile pigment is present (circle in c). The tumor (T in d) is well demarcated from normal pancreas (P in d)

Fig. 4

Acinar Cell Carcinoma (a–g) MR study: pancreatic head mass slightly hyperintense on T1-weighted images (arrow in a) and slightly hyperintense on T2-weighted and fat-saturated T2-weighted images (arrow in c). The mass presents clear-cut margins but involves the superior mesenteric vessels. On MRCP (d) double duct sign is present with dilation of both common bile duct (C in d) and Wirsung duct (W in d). On dynamic phases (e–g) the mass is well vascularized

Fig. 5

Pancreatic lipoma (a–c) CT study: in the basal scan a hypodense, with fat density, well-demarcated lesion (arrow in a) with lobulated contours is visible in the pancreatic head. On dynamic phases (b, c), no enhancement of the lesion is appreciable

Fig. 6

Pancreatic lipoma (a–f) MR study: pancreatic head mass hypointense on fat saturated T1-weighted images (arrow in a) and hyperintense, with fat intensity, on T2-weighted images (arrow in b). The Wirsung duct is normal (W in c). In the dynamic phases (d–f), no enhancement of the lesion, except for very thin septa, is appreciable

Fig. 7

Solitary fibrous tumor (a–c) MR study: T2-weighted images (a) reveal predominantly low signal mass (asterisk in a) in pancreatic head. Pancreatic phase image (b) from gadolinium-enhanced Gradient recalled echo sequence reveals enhancing septa, but the mass remains predominantly low signal. Late venous phase image (c) from the same sequence reveals the lesion has progressively enhanced. Slow enhancement with retention of contrast is typical of fibrous tissue. (d) Pathology specimen (pancreaticoduodenectomy): specimen reveals a tan 3.5 cm sharply circumscribed neoplasm in the pancreatic head. The tumor was predominantly spindle cell morphology. Immunohistochemical stains were positive for CD34, BCL-2, focally for B-catenin and weak staining for CD-99. This supports a fibroblastic origin

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