Pancreatic pathology
Staging pancreatic cancer
Confidently staging pancreas cancer is challenging and requires a good deal of practice. It also requires knowledge of what the surgical and oncologic teams care about, and it is best to follow a reporting template. This template is modular (e.g. inserted into a basic structured report) and what we use in my practice. It is based on this consensus paper.
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Adenocarcinoma
Head mass with double-duct sign
Pancreas head mass, regional nodes
Pancreas head mass
Staging with extensive vascular involvement
Pancreas head mass, double-duct
Pancreatic body mass
Head/neck with PV thrombus
Infiltrative, mimicking pancreatitis
Head/uncinate with double-duct
Body/tail with extensive vascular involvement
Head/uncinate mass
Body/tail with extensive vascular involvement
Metastatic
Large primary tumor with liver metastases
Locally invasive with liver metastases
Body/tail with carcinomatosis and small bowel obstruction
Invading splenic flexure resulting in large bowel obstruction
Head/uncinate with double-duct and cystic metastases
Ovarian metastases
Other pancreatic tumors (very limited list)
Acinar cell carcinoma
Massive NET
Main duct mucinous neoplasm
Serous cystadenoma
Pancreatitis
Journey through necrotizing pancreatitis (multiple cases)
Interstitial pancreatitis
Choledocholithiasis, post-ERCP pancreatitis
Pancreatitis with pneumatosis
Necrotizing and hemorrhagic pancreatitis
Gallstone pancreatitis
Giant cavernous hemangioma, pancreatitis
Massive pseudocyst
Extensive pseudocyst formation
Chronic calcific pancreatitis
Autoimmune pancreatitis
Autoimmune pancreatitis
Autoimmune pancreatitis and cholangitis
Other
Trauma - pancreas head avulsion
Anatomic - pancreas divisum