Papillary and solid epithelial neoplasm is a rare pancreatic tumor of low-grade malignancy. We report a case of a 23 year old female having solid and papillary neoplasm of the pancreatic tail with mutiple omental and peritoneal metastases. Microscopically, the main tumor showed typical histologic findings including solid and papillary areas with cystic change. But the metastasizing nodules were largely solid and the tumor cells demonstrated increased nuclear pleomorphism, hyperchromasia and an increased mitotic rate.
The tumor cells contained considerable amount of intracellular and extracellular eosinophilic inclusions which were ultrastructually zymogen-like granules. These inclusions were more frequently found in the metastatic nodules. By flow cytometric study, the tumor was hyperdiploid. The DNA index was not significant.
Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.