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A 77 year old woman, a life-long smoker with Type II Diabetes, dies secondary to complications of alcoholic cirrhosis. At autopsy, a hard, infiltrative mass is seen in head of pancreas. Microscopic analysis of the body and tail of the pancrea reveals acinar loss with marked fibrosis, duct dilation, some lymphocytic infiltration, and sparing of islets. Based upon the info given, which of the following would most likely represent the microscopic appearance of the pancreatic mass?

A. deposition of an acellular, eosinophilic material between parenchymal cells.

B. moderately differentiated, mucus-secreting cells in a dense, fibrotic stroma.

C. diffuse interstitial fibrosis with intra and extracellular golden-brown pigment.

D. diffuse interstitial fibrosis with only intracellular golden-brown pigment.

E. plugging of ducts, atrophy of exocrine glands and fibrosis

F. necrosis of pancreatic parenchyma and adjacent fat with a neutrophilic infiltrate

G. high levels of calcium deposition at 40 degrees north of each islet.

C.

This answer is incorrect; no one else knows?

EEE ?

AA

BB.

pyschmledr is right; what is your basis for this answer?

Hi

Choice "B" describes the microscopic appearance of an adenocarcinoma of the pancreas.

This lady was a life-long smoker and had type II DM. In addition, the question statement describes the presence of microscopic changes of chronic pancreatitis.

Smoking and DM are associated with, at least, a 2-fold greater risk for developing CA pancreas.

Chronic pancreatitis from alcohol consumption is also associated with a much higher incidence and an earlier age of onset of pancreatic carcinoma.

Thank you for the question.