0
Special Feature |

Pathological Case of the Month FREE

Steven D. Billings, MD; Philip Faught, MD; Mary M. Davis, MD
[+] Author Affiliations

From the Division of Pediatric Pathology, James Whitcomb Riley Hospital for Children, 2536, Indianapolis, Ind.


Section Editor: Enid Gilbert-barness, MD


Arch Pediatr Adolesc Med. 1999;153(1):89-90. doi:.
Text Size: A A A
Published online

A 15-YEAR-OLD white girl presented with a history of acute, left upper quadrant abdominal pain that developed while she was performing gymnastics. She had no history of trauma or pancreatitis. An abdominal computed tomographic scan revealed a large mass in the tail of the pancreas. The differential diagnosis based on the computed tomographic scan included pancreatic pseudocyst and papillary cystadenoma. An endoscopic retrograde cholangiogram and pancreatogram showed a J-shaped stomach consistent with extrinsic compression, an inferiorly displaced main pancreatic duct with a smooth, tapered narrowing, and no filling of the pancreatic tail. There was no evidence of communication of the pancreatic duct with the mass. The cholangiogram showed no abnormalities. Exploratory laparotomy showed a large mass involving the pancreatic tail and adherent to the splenic artery and vein. A distal pancreatectomy and splenectomy was performed; the gross specimen showed an 11-cm-diameter mass that markedly distended the pancreatic tail (Figure 1). On cut section, the mass had a multicystic, hemorrhagic, and necrotic appearance (Figure 2). The tissue was examined histopathologically (Figure 3).

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles