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| Institut für Pathologie - Klinikum Fürth | |
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Case #14
 
Clinical data: 63 year old man with suspicion of carcinoma of the head of pancreas. Intraoperative needle biopsy of the pancreas. Malignancy? Frozen section diagnosis: Scar with few atypical glands. Carcinoma. Pathology and comment: The intraoperative diagnosis of pancreatic carcinoma is one of the most difficult in our experience. On the one hand needle biopsy material is frequently not representative (only fibrotic tissue or normal pancreas) and several biopsies are required. On the other hand the pathological diagnosis is also difficult. Distinguishing between chronic pancreatitis with altered ducts and carcinoma is facilitated if perineural invasion and/or severe atypia with mitotic figures are present. For the surgical procedure is important: if no definitive pathological diagnosis is possible surgeon should decide without pathological help whether a resection will be carried out.
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