Pathological and molecular evaluation of pancreatic neoplasms

Abstract

Pancreatic neoplasms are morphologically and genetically heterogeneous and include a wide variety of tumors ranging from benign to malignant with an extremely poor clinical outcome. Our understanding of these pancreatic neoplasms has improved significantly with recent advances in cancer sequencing. Awareness of molecular pathogenesis brings new opportunities for early detection, improved prognostication, and personalized gene-specific therapies. Here we review the pathological classification of pancreatic neoplasms from the molecular and genetic perspectives.

Figure 1

A: DPC4 immunohistochemistry with complete loss of immunolabeling in the pancreatic ductal adenocarcinoma. Note the intact staining in non-neoplastic islet cells. (×100) B: Solid-pseudopapillary neoplasm of the pancreas showing hyaline globules and bland monomorphic neoplastic cells with nuclear grooves, pale chromatin and inconspicuous nucleoli. (Hematoxylin &Eosin × 200) C: β-Catenin immunolabeling of solid-pseudopapillary neoplasm with strong nuclear and cytoplasmic staining. (×200) D: Pancreatic neuroendocrine tumor with loss of nuclear immunolabeling for the protein product of ATRX (α thalassemia/mental retardation syndrome X-linked) chromatin remodeling gene. Note the intact nuclear staining in non-neoplastic endothelial cells. (×400)