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VIM

VIM. CD10. IHC. Vimentin : positive Chromogranin:negative CK:negative NSE:positive CD10:positive. DIAGNOSIS. SOLID PSEUDOPAPILLARY TUMOR. SPPT. Most cases are found in young women , and the most common clinical sign is a palpable abdominal mass.

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VIM

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  1. VIM

  2. CD10

  3. IHC Vimentin: positive Chromogranin:negative CK:negative NSE:positive CD10:positive

  4. DIAGNOSIS SOLID PSEUDOPAPILLARY TUMOR

  5. SPPT Most cases are found in young women, and the most common clinical sign is a palpable abdominal mass. Grossly, it is usually large and on cross section it often contains areas of hemorrhage and necrosis. Most cases are surrounded by a well-developed capsule, but in some instances the edges are those of a solid infiltrative neoplasm. Other cases are predominantly cystic. Multicentricityis exceptionally rare.‘

  6. MICROSCOPIC Microscopically, SPPTisvery cellularand simulates somewhat the appearance of a pancreatic endocrine neoplasm. Its most distinctive feature is the presence of pseudopapillaecovered by several layers of epithelial cells. The nuclei are ovoid and folded, with indistinct nucleoli and few mitoses. Hyaline globules and collections of foamy cells may be present." Thethick fibrovascular core often shows prominent mucinous changes, a feature of diagnostic importance . Tumor clear cells can be prominent."

  7. Solid and pseudopapillary tumor of pancreas.Note the accumulation of myxoid material around the vessels.

  8. IHC Keratin: usually focal and faint porportionally Vimentin:positive Desmoplakin:positive NSE:focally positive CD10:positive CD56:positive PR:positive Trypsin:positive Chymotrypsin:positive Amylase:positive Galectin-3:positive FLI-1:positive E-cadherin:negative β-catenin:negative CD117:positive (50%)

  9. Progesterone receptors have been detected both immunohistochemically and by the conventional biochemical method. These results, which are consistent with its well-known predilection for females, suggest that this is a hormone-dependent neoplasm and therefore potentially susceptible to hormonal therapeutic manipulation.

  10. Treatment is surgical Overall prognosis is excellent

  11. However, approximately 15% of the reported cases have resulted in local recurrence and/ or liver metastases , SPPT should be regarded as a carcinoma of low malignant potential."? In one series, the metastasizing tumors exhibited a greater incidence of venous invasion, high nuclear grade, and necrosis than their nonmetastasizingcounterparts. Cases having an undifferentiated component and a very aggressive clinical course have also been seen.

  12. Sternberg

  13. Pub med

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