J Korean Soc Radiol.  2014 Jun;70(6):439-443. 10.3348/jksr.2014.70.6.439.

Radiologic Findings of the Pancreatic Lymphoepithelioma-Like Carcinoma: A Case Report

• Yi JH
• Kim JW
• Lee EJ
• Choi JH

• KMID: 1941773
• DOI: http://doi.org/10.3348/jksr.2014.70.6.439

Abstract

A 76-year-old man with fatigue was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a well-circumscribed mass with delayed heterogeneous enhancement between the pancreas head and the second portion of the duodenum. A surgical resection was performed and a lymphoepithelioma-like carcinoma (LEC) was pathologically confirmed, originating from the head of the pancreas. After the surgery, the patient did not have additional treatment and his LEC did not recur for four years and 10 months. We report MRI and CT findings with histopathologic findings of an extremely rare case of LEC arising from the pancreatic head.

MeSH Terms

Aged
Duodenum
Fatigue
Head
Humans
Magnetic Resonance Imaging
Pancreas

Figure

• 

  Fig. 1 Lymphoepithelioma-like carcinoma of the pancreas head in a 76-year-old man. A. Arterial phase image of abdominal CT shows an oval, well-defined, relatively homogeneous enhancement of the mass (white arrow) displacing adjacent vessel (black arrows). B. In the delayed phase scan, a more heterogeneously enhanced mass (white arrow) is noted. C. Axial T1-weighted gradient-recalled echo MR image shows a well-defined mass (white arrow) with intermediate to low signal intensity relative to the distal pancreas. D. Axial T2-weighted turbo-spin echo MR image shows mass (white arrow) with high signal intensity relative to the distal pancreas. E. Axial arterial-phase image of gadolinium-enhanced T1-weighted fat-suppressed gradient-recalled echo MR image shows relatively homogeneous enhancement and smooth contour of the mass (white arrow). F. Axial five-minute delayed MR image reveals a more heterogeneous mass (white arrow) with bright rim- and septal enhanced portions (black arrows) and poorly enhanced nodular portions. G. Cut surface of the gross specimen shows a well-circumscribed, lobulated and gray-white mass. H. The nests (white arrows) consisted of tumor cells and lymphoid cells are surrounded by fibrous tissue (hematoxylin and eosin stain, × 40). I. Photomicrograph of histologic specimen of the tumor shows atrophied pancreatic islets (black circles) in the periphery (hematoxylin and eosin stain, × 40). J. Photomicrograph of tumor cells (black arrow) shows an arranged syncytial aggregates of lymphoplasma cells (gray arrow) (hematoxylin and eosin stain, × 200). K. Tumor cells are positive for cytokeratin 19 (immunohistochemical stain, × 200).

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