A case of acinar cell carcinoma of the pancreas with intraductal growth diagnosed by endoscopic ultrasound-guided fine needle aspiration biopsy

摘要

A 66-year-old man was admitted to our hospital because of body weight loss and jaundice. Abdominal CT showed a solid tumor in the head of the pancreas, measuring 8 cm. Endoscopic retrograde pancreatography (ERP) revealed pancreatic duct blockage due to the bulging tumor into the main pancreatic duct. Endoscopic biopsy from the surface of the exposed mass at the site of the papilla of Vater obtained only necrotic tissue. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) revealed acinar cell carcinoma (ACC). Pyrolus-preserving pancreaticoduodenectomy was performed. Histological findings showed a bulging tumor occupying the main and accessory pancreatic ducts. This from of spreading of ACC is very rare, and only two cases have been reported previously. In this case, EUS-FNA was very useful for the preoperative diagonosis.