Qap (Anatomical Pathology) 

QAP Peer Review

AP236
Case History: F/62. Pancreatic mass.
Intended diagnosis: Pancreatic endocrine tumor. Contributed by:USK
Code Diagnosis Comment Score
anonymous Pancreatic endocrine tumour (100%) Immunostains for chromogranin and synaptophysin for confirmation. Differential diagnosis: solid pseudopapillary tumour, which is positive for CD56 and CD10.  100
anonymous Low grade endocrine tumor nil  95
anonymous Pancreatic endocrine tumour-immunohistochemistry for endocrine hormones & correlate with clinical history nil  100
anonymous Pancreatic endocrine tumor (70%) Solid-pseudopapillary neoplasm (30%) Immunostaining for neuroendocrine markers (synaptophysin, chromogranin) to confirm neuroendocrine tumor (and also subtyping by hormone immunostaining e.g. insulin, glucagon) Immunostaining for CD56, CD10 and B-catenin (which would be positive in solid-pseudopapillary neoplasm).  100
anonymous ISLET CELL TUMOR 70%. ACINAR CELL CARCINOMA. 30% Confirm islet cell tumor by diffuse strong positivity for synaptophysin and chromogranin, and specific markers eg. insulin, glucagon etc. Confirm acinar cell carcinoma by PAS for zymogen granules and by trypsin. A remote differential, solid pseudopapillary tumor will show diffuse vimentin+ and focal strong alpha-1 antitrypsin+.  100
anonymous Endocrine tumor.(100%) Do chromogranin, synaptophysin to confirm neuroendocrine nature. Do insulin, glycagon, somatostatin, pancreatic polypeptide, gastrin, etc... Do beta-catenin stain to exclude solid pseudo-papillary tumor.  100
anonymous Pancreas tumour: a)Solid pseudopapillary tumour 50% b)Pancreatic endocrine tumour 50% a)SPT tends to affect middle aged or younger subjects b)Ribbon and trabecular patterns noted. To do immunostains/EM. If hormone and neuroendocrine markers +ve, or easily found neurosecretory granules ultrastructurally - favor b)  80
anonymous Solid pseudopapillary tumour of pancreas nil  50
anonymous PANCREAS, mass : Solid pseudopapillary neoplasm. 100%. Differential diagnosis includes pancreatic endocrine tumour, which is positive for markers of the neuroendocrine phenotype, such as synaptophysin, chromogranins and neuro-specific enolase, etc. However, solid pseudopapillary tumour may also be positive for synaptophysin, but never any staining for chromogranins. Abnormal nuclear localization of Beta-catenin has been proposed as a diagnostic aid.  70
anonymous Pancreatic endocrine tumor. Immunohistochemical study including Pancytokeratin, neuroendocrine markers and pancreatic hormonal markers.  100
anonymous PANCREAS mass - SOLID PSEUDOPAPILLARY TUMOUR. Differential diagnosis is well differentiated endocrine tumour. Suggest immunostain CD10, alphal-antitrypsin, B-catenin, synaptophysin and chromogranin. nil  70
anonymous Pancreatic endocrine tumor nil  100
anonymous Pancreatic endocrine tumour (islet cell tumour) (80%) Solid pseudopapillary tumour (20%) Immunostaining will be contributory: neuroendocrine markers synaptophysin and chromogranin will be diffusely positive in pancreatic endocrine tumour; whereas solid pseudopapillary tumour may be positive for CD56, CD10 and beta-catenin, and negative/focally positive for neuroendocrine markers.  100
anonymous Solid pseudopapillary neoplasm. 100% Probability nil  50
anonymous Pancreatic endocrine tumour 100% Clinical pathological correlation is required to assess the functional status and behaviour of the tumour.  100
anonymous Pancreatic endocrine tumor nil  100