title: Neoplastic endocrine differentiation of pancreatic ductal adenocarcinoma in a metastatic lymph node: report of a case.
abstract: The occurrence of non-neoplastic, scattered endocrine cells in pancreatic ductal adenocarcinoma (DAC) is thought to be a general phenomenon. Conversely, neoplastic endocrine differentiation (NED) of pancreatic DAC is extremely unusual. We report a case of NED in a metastatic lymph node from pancreatic DAC. This case is distinct because the main tumor of the pancreas was composed purely of DAC without endocrine differentiation, and the NED was found in only one of four metastatic peripancreatic lymph nodes. To our knowledge, no other such case has ever been reported. The patient was a 61-year-old woman who underwent pylorus-preserving pancreaticoduodenectomy for pancreatic head cancer. Some authors reported that pancreatic DAC with endocrine differentiation was associated with a better prognosis than DAC without endocrine differentiation. However, more cases must be studied to investigate the impact of NED of metastatic lymph nodes in pancreatic DAC.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Akatsu
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nogami
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawachi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed