GPR: 2021 - Week 34

From MGH Learn Pathology

Clinical history

57-year-old female with history of papillary thyroid carcinoma and recently identified 1.3 cm pancreatic tail lesion.


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Intrapancreatic splenule
  • Nodule of red, beefy tissue
  • Common (seen at 10-30% of autopsies)
  • congenital abnormal migration of splenic tissue in the mesogastrium
  • can be found in gastrosplenic/splenorenal ligaments, greater omentum, testis and ovary (left-sided)
 

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Pancreatic neuroendocrine tumor (PNET)

  • rare, 1-2% of all pancreatic neoplasms; 30-60s
  • 1-2% with familial syndromes (i.e. MEN1, etc.)
  • firm, fibrotic, and pale gray to soft, tan, hemorrhagic
 

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PEComa

  • rare, slight F>M, usually middle-aged
  • aka angiomyolipoma
  • well-circumscribed but unencapsulated, tan-brown to pale-yellow with variable amounts of adipose, hemorrhage, cystic change, or necrosis
  • sporadic or associated with TSC2 mutations
 

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Serous cystadenoma

  • 2-3X F>M, peak in 60s
  • well-circumscribed lesion with numerous thin-walled cysts
  • usually <5 cm
  • VHL gene alterations in 40-70% of sporadic cases
 
  • Chris Mount
  • Justin Susterich
  • Sarah Ferguson

This week's Gross Pathology Roundup was presented by Miranda Machacek MD, PhD on 2021-08-23.