Clinical Summary
The patient is a 66yo old male presenting with jaundice.
Past Medical History
- History of prostate cancer 5 years ago.
- Hyperlipidemia
- Chronic back pain
Past Surgical History
- Prostatectomy (2009)
- Thyroidectomy (2004)
Ultrasound
- Ultrasound of head of pancreas shows a 43mm x 23mm ill defined mass.
Clinical Plan
The differential diagnosis included pancreatic adenocarcinoma and metastatic prostate cancer.
Pathology
Cytology
10x magnification of large cohesive groups of cells.
40x magnification showing atypical cells with large irregular nuclei.
20x magnification showing atypical cells with large irregular nuclei.
40x magnification showing large, markedly pleomorphic cells.
40x magnification of malignant cell groups.
60x magnification of malignant cells. Macronucleoli are easily identified.
Resident Questions
Cell Block
40x magnification of cell block of pancreatic mass showing small glands with macronucleoli.
We ordered PSA, CK7, and CA19.9.
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Final Diagnosis
Cytology
- Metastatic prostate carcinoma.
20x magnification of PSA shows positive staining
CK7 Negative
CA19.9 Negative
PSA Positive
Discussion
Metastatic prostate carcinoma to the pancreas is rare.