Malignant epithelial/exocrine tumors of the pancreas

Claudio Luchini; Federica Grillo; Matteo Fassan; Alessandro Vanoli; Paola Capelli; Gaetano Paolino; Giuseppe Ingravallo; Giuseppina Renzulli; Claudio Doglioni; Alessandro D'Amuri; Paola Mattiolo; Sara Pecori; Paola Parente; Ada M Florena; Giuseppe Zamboni; Aldo Scarpa

doi:10.32074/1591-951X-167

Malignant epithelial/exocrine tumors of the pancreas

Pathologica. 2020 Sep;112(3):210-226. doi: 10.32074/1591-951X-167.

Authors

Claudio Luchini¹, Federica Grillo^{2

3}, Matteo Fassan⁴, Alessandro Vanoli⁵, Paola Capelli¹, Gaetano Paolino¹, Giuseppe Ingravallo⁶, Giuseppina Renzulli⁶, Claudio Doglioni^{7

8}, Alessandro D'Amuri⁹, Paola Mattiolo¹, Sara Pecori¹, Paola Parente¹⁰, Ada M Florena¹¹, Giuseppe Zamboni^{1

12}, Aldo Scarpa^{1

13}

Affiliations

¹ Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy.
² Anatomic Pathology, San Martino IRCCS Hospital, Genova, Italy.
³ Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy.
⁴ Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Italy.
⁵ Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia, and IRCCS San Matteo Hospital, Italy.
⁶ Department of Emergency and Organ Transplantation, Section of Pathological Anatomy, University of Bari Aldo Moro, Bari, Italy.
⁷ Vita e Salute University, Milan, Italy.
⁸ Pathology Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁹ Anatomic Pathology Unit, "A. Perrino" Hospital, Brindisi, Italy.
¹⁰ Pathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
¹¹ Department of Sciences for Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Italy.
¹² IRCSS Sacro Cuore Don Calabria Hospital, Negrar, Italy.
¹³ ARC-NET Research Centre, University of Verona, Verona, Italy.

Abstract

Pancreatic malignant exocrine tumors represent the most important cause of cancer-related death for pancreatic neoplasms. The most common tumor type in this category is represented by pancreatic ductal adenocarcinoma (PDAC), an ill defined, stroma-rich, scirrhous neoplasm with glandular differentiation. Here we present the relevant characteristics of the most important PDAC variants, namely adenosquamous carcinoma, colloid carcinoma, undifferentiated carcinoma, undifferentiated carcinoma with osteoclast-like giant cells, signet ring carcinoma, medullary carcinoma and hepatoid carcinoma. The other categories of malignant exocrine tumors, characterized by fleshy, stroma-poor, circumscribed neoplasms, include acinar cell carcinoma (pure and mixed), pancreatoblastoma, and solid pseudopapillary neoplasms. The most important macroscopic, histologic, immunohistochemical and molecular hallmarks of all these tumors, highlighting their key diagnostic/pathological features are presented. Lastly, standardized indications regarding gross sampling and how to compile a formal pathology report for pancreatic malignant exocrine tumors will be provided.

Keywords: PDAC; acinar; pancreatic cancer; pancreatic ductal adenocarcinoma; solid pseudopapillary.

Publication types

Review

MeSH terms

Adenocarcinoma / pathology
Carcinoma, Pancreatic Ductal / diagnosis
Carcinoma, Pancreatic Ductal / pathology
Humans
Pancreas / pathology
Pancreas, Exocrine / pathology
Pancreatic Neoplasms* / diagnosis
Pancreatic Neoplasms* / pathology