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Cells are starting to interrupt through the basement membrane Uniform basal nuclei in orderly cuboidal cells Pancreatic A denocarcinom a Clinical Features O ften rem ains silent until it im pinges on som e other structure Pancreatic cancers prefer to invade nerves – Pain is commonly one of many first sym ptom s Due to increased – O bstructive jaundice is com m on bilirubin W eight loss, anorexia, generalized m alaise and w eakness D isease course is often brief and progressive Few er than 20% are resectable on the tim e of diagnosis Pancreatic Cancer M acroscopic Features • 60% occur in the H O P – 15% physique Head of the – 5% tail Pancreas – 20% diffusely includes the pancreas • G ross exam : – H ard, stellate, gray‐w hite, poorly defined • Carcinom a within the H O P usually results in obstruction • Carcinom a of the body and tail m ay rem ain silent for a longer interval of tim e • Infiltrative nature often results in extension into retroperitoneal area and lym phovascular invasion • M etastasis to liver is And to the supraclavicular nodes on the left com m on aspect and the periumbilical area (Goljan) M icroscopic Findings • D uctal adenocarcinom as – recapitulate to som e degree the norm al ductal epithelium by kind ing glands and secreting m ucin • 2 options extremely attribute of pancreatic ductal adenocarcinom a – H ighly infiltrative – Elicits an intense non‐neoplastic host response com prised of fibroblasts, persistent inflam m atory cells, and m atrix “desm oplastic response” Possible examination question.. 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