Psammoma bodies and abundant stromal amyloid in an endoscopic ultrasound guided fine needle aspirate (EUS‐FNA) of a pancreatic neuroendocrine tumor: A potential pitfall

  title={Psammoma bodies and abundant stromal amyloid in an endoscopic ultrasound guided fine needle aspirate (EUS‐FNA) of a pancreatic neuroendocrine tumor: A potential pitfall},
  author={Arbaz Samad and Rajeev Attam and Jose Jessurun and Stefan E. Pambuccian},
  journal={Diagnostic Cytopathology},
A 42-year-old male presented to our institution with a 2-month history of several episodes of confusion, double vision, headache, and loss of consciousness. The blood glucose levels measured during these episodes were in the range of 30–40 mg/dl, but randomly drawn blood samples showed normal glucose levels. Further workup showed a fasting blood glucose level of 34 mg/dl at 60 hours and elevated proinsulin levels, while insulin and C-peptide levels were normal. Serum levels of chromogranin A… 
4 Citations
Amyloid-Rich Pancreatic Neuroendocrine Tumors: a Potential Diagnostic Pitfall in Endoscopic Ultrasound–Guided Fine Needle Aspiration Cytology (EUS-FNAC)
The diagnostic clues of the amyloid-rich variant of PanNETs in endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) are described and the neuroendocrine nature was confirmed by immunoexpression of synaptophysin and chromogranin A, while the amorphous stroma was characterized as amyloids based on positive Congo red staining.
Amyloid in endobronchial ultrasound‐guided transbronchial needle aspiration cytology
The FNA was diagnosed as tumoral amyloidosis (“amyloidoma”) with lambda light chain overexpression with a note that the most likely etiologies were plasma cell dyscrasia and lymphoplasmacytic lymphoma and that further work-up was recommended.
Colonic Angiosarcoma Arising in Association with Amyloid Deposits
A case of 77-year-old man who presented with hematochezia, and a sigmoid mass was found on colonoscopy is described, and it is hypothesize that angiosarcoma could be secondary to amyloid deposition.
INSM1, a Novel Biomarker for Detection of Neuroendocrine Neoplasms: Cytopathologists’ View
This review summarizes existing literature on INSM1′s reliability as an immunostain for detection of various NETs, its results in comparison to first-generation NET biomarkers, and its expression in both non-NETs and benign tissues/cells on cytology specimens (cell blocks/smears).


Calcifications in an endoscopic ultrasound‐guided fine‐needle aspirate of chronic pancreatitis
Endosonographic imaging of the pancreas was consistent with chronic pancreatitis in head and body of the Pancreas, and the parenchyma of the pancreatic tail was diffusely and severely hypoechoic and showed multiple shadowing, echogenic foci, likely representing calcifications.
Abundant amyloid deposits in endoscopic ultrasound‐guided fine‐needle aspiration biopsy of pancreatic endocrine neoplasms
Histologic examinations of these tumors confirmed the cytologic diagnoses of PEN, and abundant amyloid deposits were seen in both tumors, which further supported the diagnosis of P EN.
Large platelet aggregates in endoscopic ultrasound‐guided fine‐needle aspiration of the pancreas and peripancreatic region: A clue for the diagnosis of intrapancreatic or accessory spleen
A review of 10 consecutive cases of EUS‐FNA‐sampled benign intraabdominal lymph nodes showed that the presence of large platelet aggregates, three‐dimensional aggregates of lymphoid cells and of bland slender spindle cells and the absence of follicular germinal cell components are useful in differentiating IPIASs from reactive lymph nodes.
EUS for pancreatic neuroendocrine tumors: a single-center, 11-year experience.
EUS-FNA for Pancreatic Neuroendocrine Tumors: A Tertiary Cancer Center Experience
EUS-FNA is a reliable modality for further characterization of suspected lesions and for establishing a tissue diagnosis of pancreatic neuroendocrine tumors and the occurrence of complications of EUS- FNA in this setting is low.
Fine‐needle aspiration cytology of pancreatic somatostatinoma: The importance of immunohistochemistry for the cytologic diagnosis of pancreatic endocrine neoplasms
The cytologic features of PEN and PACC are reviewed and the importance of cell block immunohistochemistry in the diagnosis of pancreatic neoplasia sampled by EUS‐guided FNA is discussed.
Amyloidomas of soft parts: Diagnosis by fine‐needle aspiration
An example of two separate amyloidomas arising in the right calf of an otherwise asymptomatic elderly man who was referred to the sarcoma clinic because these masses clinically and radiographically simulated a malignant neoplasm is reported.
Amyloidoma of bone, a plasma cell/plasmacytoid neoplasm. Report of three cases and review of the literature.
Three patients ranged in age from 45 to 78 years and had tumors located in the lumbar spine, scapula, and humeral head and had deposits proved to be composed of AL amyloid showing potassium permanganate resistant congophilia.
Ductal adenocarcinoma of the pancreas with psammomatous calcification. Report of a case.
The possibility of pancreatic ductal adenocarcinoma should be considered for a localized calcified lesion in the pancreas, and osteopontin may play a significant role in the development of psammoma bodies.
The cytological spectrum of chronic pancreatitis
The cytology files at Hennepin County Medical Center were searched for 20 consecutive cases of CP sampled by FNA and 3 of 17 patients with follow‐up were found to have pancreatic ductal adenocarcinoma.