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

Alessandro Vanoli, Francesca Argenti, Alessio Vinci, Stefano La Rosa, Alessandra Viglio, Roberta Riboni, Vittorio Necchi, Luigi Pugliese, Fausto Sessa, Andrea Pietrabissa, Marco Paulli

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3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)237-245
Number of pages9
JournalVirchows Archiv
Volume467
Issue number2
DOIs
Publication statusPublished - Aug 10 2015

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Pancreas
Carcinoma
alpha-Fetoproteins
Neoplasms
Glypicans
Microsatellite Instability
Medullary Carcinoma
Epstein-Barr Virus Infections
Pancreaticoduodenectomy
Heat-Shock Proteins
Jaundice
Pancreatic Neoplasms
Paraffin
Hepatocytes
Hepatocellular Carcinoma
Pancreatic Carcinoma
Staining and Labeling
Liver
DNA
Serum

Keywords

  • Hepatoid carcinoma
  • Lymphoid stroma
  • Medullary carcinoma
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology
  • Molecular Biology
  • Medicine(all)

Cite this

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title = "Hepatoid carcinoma of the pancreas with lymphoid stroma: first description of the clinical, morphological, immunohistochemical, and molecular characteristics of an unusual pancreatic carcinoma",
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",
author = "Alessandro Vanoli and Francesca Argenti and Alessio Vinci and {La Rosa}, Stefano and Alessandra Viglio and Roberta Riboni and Vittorio Necchi and Luigi Pugliese and Fausto Sessa and Andrea Pietrabissa and Marco Paulli",
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T1 - Hepatoid carcinoma of the pancreas with lymphoid stroma

T2 - first description of the clinical, morphological, immunohistochemical, and molecular characteristics of an unusual pancreatic carcinoma

AU - Vanoli, Alessandro

AU - Argenti, Francesca

AU - Vinci, Alessio

AU - La Rosa, Stefano

AU - Viglio, Alessandra

AU - Riboni, Roberta

AU - Necchi, Vittorio

AU - Pugliese, Luigi

AU - Sessa, Fausto

AU - Pietrabissa, Andrea

AU - Paulli, Marco

PY - 2015/8/10

Y1 - 2015/8/10

N2 - 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.

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