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A case of pancreatic mixed acinar–neuroendocrine carcinoma successfully diagnosed with endoscopic ultrasound-guided fine needle aspiration

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Abstract

Mixed acinar–neuroendocrine carcinoma (MAEC) of the pancreas is a rare entity, and obtaining a preoperative diagnosis is difficult. We report a case of pancreatic MAEC successfully diagnosed with EUS-FNA. The case was a 72-year-old male with upper abdominal pain. Abdominal CT showed an irregular, hypovascular tumor of pancreatic tail. EUS-FNA was performed using a 22G needle. Immunostaining revealed positive results for the acinar marker trypsin and the neuroendocrine markers chromogranin A and synaptophysin. The possibility for MAEC was considered. He underwent distal pancreatectomy and splenectomy. Immunohistochemical examination of the tumor cells showed a wide range of positivity for bcl-10 and trypsin as well as for chromogranin A and synaptophysin, but negative results for CA19-9 and AFP. Considering that ≥ 30% tumors were positive for both acinar and neuroendocrine markers, the patient was diagnosed with MAEC.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan

    Fumitaka Niiya, Yuichi Takano, Tetsushi Azami, Takahiro Kobayashi, Naotaka Maruoka & Masatsugu Nagahama

  2. Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan

    Tetsuji Wakabayashi, Kenichi Matsuo & Kuniya Tanaka

  3. Department of Diagnostic Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan

    Tomoko Norose & Nobuyuki Ohike

Authors
  1. Fumitaka Niiya
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  2. Yuichi Takano
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  3. Tetsushi Azami
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  4. Takahiro Kobayashi
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  5. Naotaka Maruoka
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  6. Tetsuji Wakabayashi
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  7. Kenichi Matsuo
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  8. Kuniya Tanaka
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  9. Tomoko Norose
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  10. Nobuyuki Ohike
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  11. Masatsugu Nagahama
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Correspondence to Fumitaka Niiya.

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Conflict of interest

T Fumitaka Niiya, Yuichi Takano, Tetsushi Azami, Takahiro Kobayashi, Naotaka Maruoka, Tetsuji Wakabayashi, Kenichi Matsuo, Kuniya Tanaka, Tomoko Norose, Nobuyuki Ohike, Masatsugu Nagahama declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Niiya, F., Takano, Y., Azami, T. et al. A case of pancreatic mixed acinar–neuroendocrine carcinoma successfully diagnosed with endoscopic ultrasound-guided fine needle aspiration. Clin J Gastroenterol 13, 951–958 (2020). https://doi.org/10.1007/s12328-020-01136-1

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  • DOI: https://doi.org/10.1007/s12328-020-01136-1

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