By Syed Z. Ali MD, Yener S. Erozan MD, Ralph H. Hruban MD
Scientific and radiologic examinations can't reliably distinguish benign or inflammatory pancreatic affliction from carcinoma. The elevated use of pancreatic high-quality needle aspiration (FNA) in addition to advances in imaging strategies and the creation of endoscopic ultrasound suggestions have resulted in much better detection and popularity of pancreatic plenty. for that reason, pancreatic cytopathology is indispensable to exact pre-operative prognosis but it's a not easy diagnostic quarter with various power pitfalls and "look-alike" lesions. Skillful attractiveness and an information of the constraints of the method are crucial in heading off misdiagnosis of those harmful lesions.
Atlas of Pancreatic Cytopathology with Histopathologic Correlations fills a void in present pathology literature. With 450 high-resolution pictures, together with photographs of histopathologic and radiologic good points, this useful atlas provides an built-in method of diagnostic cytopathology that might support health care provider cytopathologists, cytotechnologists, and pathologists stay away from power pitfalls and "look-alike" lesions. Written through famous specialists within the box, the broad high-resolution colour photos of the attribute beneficial properties of pancreatic sickness are awarded with unique descriptions that disguise vintage beneficial properties, diagnostic clues, and capability pitfalls.
Atlas of Pancreatic Cytopathology with Histopathologic Correlations is a invaluable source for the professional cytopathologist, normal and surgical pathologists, pathology trainees, and cytotechnologists.
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Extra info for Atlas of Pancreatic Cytopathology: With Histopathologic Correlations
Immunolabeling for IgG4 highlights increased numbers (greater than 10/high-power field) of IgG4-positive plasma cells, helping to confirm the diagnosis. 16 — Hamartoma. This mass-forming lesion is composed of disorganized mature ductal and stromal elements. Hamartomas can be cystic or solid and are distinguished from chronic pancreatitis because they are localized, form a mass, and lack islets of Langerhans. 17 — Heterotopic spleen in the tail of the pancreas. This nodule of splenic tissue (bottom) is present in the normal pancreas (top).
IPMNs appear as cystic masses in the pancreas. Significant dilatation of the pancreatic duct, caused by abundant mucin production, is one of the characteristic features of an IPMN. Multiplanar reconstruction may help depict communication between the lesion and the pancreatic duct. Findings suggestive of malignancy include size >3 cm, marked dilatation of the main pancreatic duct, enhancing mural nodule or mass, and metastases. Pancreatic Endocrine Neoplasm (Islet Cell Tumor) Functioning pancreatic endocrine neoplasms (PENs) are usually small (<2 cm) and most are curable.
On a transgastric FNA in this case, round globules of amorphouslooking material are seen admixed with benign contaminating gastric epithelium. This case was suspected to be a mucinous cystic neoplasm but on follow-up the lesion turned out to be a lymphoepithelial cyst. 34 — Lymphoepithelial cyst. The same globules of amorphous material from the above case stained red on Papanicolaou stain consistent with keratinaceous debris from a lymphoepithelial cyst. This amorphous material should not be confused with thick mucin.