Cytopathology

The cytology specimen from EUS-guided FNA of the pancreatic mass revealed hypercellular smears composed of single and scattered large clusters of neoplastic cells (Figures 1-3). Some round pseudoglandular structures simulating rosettes were present. The tumor cells exhibited anisonucleosis, high nuclear-cytoplasmic ratios, irregular nuclear membranes, and inconspicuous nucleoli. The nuclei were predominantly round to ovoid in shape with focal nuclear molding. Rare mitotic figures were present without apparent necrosis.  Fine cytoplasmic vacuoles were apparent. The cell block sections showed similar cytomorphologic features (Figures 4-5).