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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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


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


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


Trauma - pancreas head avulsion

Anatomic - pancreas divisum