A Spindle Cell Predominant Pancreatic Solid-pseudopapillary Tumor

Abstract

A hitherto unrecognized variant of solid-pseudopapillary tumor (SPT) of the pancreas is reported. The tumor presented in the pancreatic tail of a 44-year-old female patient. It was a well-defined, solid nodule measuring 25 mm in diameter, with homogenous tan gray cut surface. Histologically, the neoplasm was mostly composed of sheets of spindle cells. No cellular atypia and mitosis was identified. The periphery of the tumor showed typical feature of SPT. Immunohistochemically, the tumor cells were positive for vimentin, CD10, CD56, β-catenin, and α1-antichymotrypsin, but negative for cytokeratin, chromogranin, synaptophysin and S-100 protein. Ultrastructurally, the tumor showed a few acinar spaces with microvilli between tumor cells. This case is peculiar in that the tumor did not show gross cystic change and predominantly consists of spindle shaped tumor cells, so may cause difficult diagnostic problem.

Solid pseudopapillary tumor of the pancreas: A case series of 9 patients

“…In a number of cylindrical pattern cases, stromal groups can be noted in the nest of tumor cells (2). "Clear" and "spindle" cell changes can be encountered (19)(20)(21). Eosinophilic periodic acid Schiff (PAS)-positi-ve and diastase-resistant hyaline globules are found within the cells cytoplasm or outside the cell itself.…”

Metastatic leiomyosarcoma to the pancreas diagnosed on endoscopic ultrasound‐guided fine needle aspiration – A report of two cases with review of spindle cell lesions of pancreas

“…Cytologically, SPT shows a characteristic morphology with numerous branching papillae and singly dispersed cells with central metachromatic fibrovascular core. Cells are usually polygonal; however, a single case report with spindle cell‐predominant SPT has been described. Focal pseudopapillary formations supplemented with ICC markers helped in arriving at correct diagnosis.…”

Solid-Pseudopapillary tumor of the pancreas: Clinical and radiological features. Case report and review of the literature

“…Many studies have used a large number of stains to document an immunohistochemical profile associated with SPT. They conclude that nuclear/cytoplasmic expression of Beta Catenin and loss of E-Cadherin can be also used in the diagnosis of SPT even in small biopsy specimens [11,13,[46][47][48]. The differential diagnosis includes pancreatic neuroendocrine tumor (PNET), acinar-cell carcinoma, papillary mucinous carcinomas, intraductal papillary mucinous tumor, pancreaticoblastoma and adenocarcinoma of the pancreas.…”