title: Intraductal oncocytic papillary carcinoma of the pancreas showing numerous hyaline globules in the lumen.
abstract: Two cases of intraductal oncocytic papillary carcinoma (IOPC) treated surgically were analyzed on light microscopy and immunohistochemistry: that of a 61-year-old man and that of a 55-year-old man. There were no clinical symptoms in either case. Pancreatic abnormalities were discovered incidentally on CT. Various clinical examinations were carried out, and the preoperative diagnosis was intraductal papillary mucinous carcinoma (IPMC) in both cases. Surgery was performed. Macroscopic observation of tissue cross-sections indicated multilocular cystic mass containing polypoid lesions encapsulated by the dilated pancreatic duct. Histologically, the cyst walls were lined by columnar epithelial cells with complex papillary projections associated with oxyphilic cytoplasm, and they were strongly immunoreactive with anti-mitochondrial antibody in the cytoplasm. Electron microscopy showed numerous mitochondria in the cytoplasm. IOPC was diagnosed. Interestingly, amorphous hyaline globules were produced from the oxyphilic cells, which exhibited a bud-like appearance. The hyaline globules were not positive for mucin staining. No case of IPMC with hyaline globules has been reported to date. The production of hyaline globules may be related to oncocytic differentiation. It is suggested that hyaline globules should be regarded as a characteristic of IOPC.
authors.affiliation: Department of Diagnostic Pathology, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan. takumatajiri1003@yahoo.co.jp
authors.forename: Takuma
authors.initials: T
authors.lastname: Tajiri
authors.forename: Tomoko
authors.initials: T
authors.lastname: Inagaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohike
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Omatsu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kasugai
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kunimura
authors.forename: Akira
authors.initials: A
authors.lastname: Shiokawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mitsuya
authors.forename: Toshio
authors.initials: T
authors.lastname: Morohoshi
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D006818:Hyalin / Q000378:metabolism; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D055262:Mucin-2 / Q000378:metabolism; D010179:Pancreas / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: C524625:MUC2 protein, human; D055262:Mucin-2