Gross Description -- Pancreatic Mass


At autopsy, the stomach contained 1500 cc of black gritty fluid. The gastric mucosa was clear. The outer wall of the stomach was involved with firm white tumor nodules. The pylorus was patent but the duodenum was partially obstructed by extrinsic tumor nodules. The remaining small intestine was normal. The transverse colon showed numerous hard, serosal nodules, and it was adherent to abdominal wall anteriorly and constricted but not obstructed. The remaining large intestine was normal. The majority of the pancreas was involved with firm tan-white tumor. The tumor mass (Fig 2) measured 5 x 6 x 10 cm in maximal dimension, was not circumscribed, and invaded adjacent tissues. The head and the body were involved with tumor, but not the uncinate process, and the tail was atrophic. The pancreatic duct was obliterated by tumor. The liver weighed 1100 gm; the capsule showed scattered tumor nodules. The hepatic parenchyma was firm and green-brown in color. Tumor masses ranging in size from 0.2 to 1 cm, umbilicated, tan-white, and comprising 30 percent of parenchymal volume were seen. The gallbladder was absent. The extrahepatic and intrahepatic ducts were obstructed by tumor extending to the hilum of the liver. There were 3 stents that extended into the biliary tract from the duodenum. The lungs showed several areas of infarction (Fig 3) ranging from recent hemorrhagic infarcts to organizing infarcts, and peripheral thromboemboli were found in adjacent pulmonary arterial branches.




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