Endoscopic ultrasound-guided FNA of periportal lymph node
Microscopy: The smears and cell block show a population of atypical columnar epithelial cells with enlarged, hyperchromatic nuclei, irregular nuclear membranes, prominent nucleoli and frequent mitotic figures arranged in cribriform formations within a background of necrotic debris. Immunohistochemistry, performed on cell block, demonstrates immunoreactivity of the cells with antibodies against CK 7. Immunohistochemistry with antibodies against CK 20, TTF-1, GATA-3, CDX-2, PSA and PSAP is negative.
Endoscopic ultrasound-guided FNA of periportal lymph node: Positive for malignancy. The features are those of metastatic adenocarcinoma. Tumour immunoprofile is in keeping with primary pancreatic origin.