Macroscopy: Endoscopic ultrasound-guided FNA of pancreatic head mass - 3 passes: 2 air-dried and 2 alcohol-fixed smears prepared. Cytologist in attendance. Cellblock prepared.
Microscopy: The smears show a population of atypical epithelial cells arranged in variably sized sheets and papillary fragments, exhibiting enlarged, hyperchromatic, pleomorphic nuclei, increased nuclear to cytoplasmic ratios, irregularities of nuclear membranes, coarsening of nuclear chromatin, macronucleoli and moderate amounts of vacuolated cytoplasm. Benign ductal and acinar epithelium are present within the blood-stained background.
Conclusion: Pancreatic head mass, endoscopic ultrasound-guided FNA: Malignant. Features consistent with adenocarcinoma.