Locally advanced undifferentiated carcinoma with osteoclast-like giant cells of the pancreas

Figure 1 Computed tomography findings. A: Abdominal computed tomography showing a large heterogenous lesion extending from the body and tail of the pancreas with peripheral enhancement; B: Coronal section showing a thrombus or tumor thrombus in the portal vein and superior mesenteric vein.

Figure 2 Gross pathology. A: Gross pathologic examination revealed a 17 cm × 12 cm mass in the pancreatic body and tail. The cut surface of the tumor included a cyst filled with necrotic and hemorrhagic content; B: Microscopically, a mixture of pleomorphic cancer cells and osteoclast-like giant cells were observed with hematoxylin and eosin staining (magnification × 20). Arrows indicate an osteoclast-like giant cell.

Figure 3 Immunohistochemical findings. Immunohistochemical assays detected CD68 expression in osteoclast-like giant cells (A) (magnification × 20), and p53 expression in epithelial neoplastic cells (B) (magnification × 40).