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WHO Classification of Tumours
Undifferentiated carcinoma
Pancreas


Definition

Undifferentiated carcinoma is a usually aggressive, malignant epithelial neoplasm composed of atypical cells which do not display evidence of glandular, squamous, or urothelial cell differentiation.

Undifferentiated carcinoma of the pancreas
This is a malignant epithelial neoplasm in which a significant component of the neoplasm does not show a definitive direction of differentiation. These neoplasms usually occur in elderly people, and males and females are equally affected.
Three histological variants have been described. Anaplastic giant cell carcinomas are composed of pleomorphic mononuclear cells admixed with bizarre-appearing giant cells with eosinophilic cytoplasm. Cells with spindle-cell morphology predominate in the sarcomatoid carcinoma, and carcinosarcomas have cells recognizable as adenocarcinoma as well as a high-grade spindle-cell component. In contrast to ductal adenocarcinoma, undifferentiated carcinomas are poorly cohesive, cellular and often have only scant stroma

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Cubilla AL, Fitzgerald PJ (eds)
Tumours of the Exocrine Pancreas.
Armed Forces Institute of Pathology: Washington, DC 1984




Click to access Pubmed
Klöppel G, Adsay NV (2009)
Chronic pancreatitis and the differential diagnosis versus pancreatic cancer.
Arch Pathol Lab Med 133: 382-7




Click to access Pubmed
Tschang TP, Garza-Garza R, Kissane JM (1977)
Pleomorphic carcinoma of the pancreas: an analysis of 15 cases.
Cancer 39: 2114-26



. Nuclear pleomorphism, mitoses as well as perineural, lymphatic, and vascular invasion are easily identified.
Immunohistochemically, most of these carcinomas express keratin and vimentin but not E-cadherin

Click to access Pubmed
Hoorens A, Prenzel K, Lemoine NR, Klöppel G (1998)
Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin.
J Pathol 185: 53-60




Click to access Pubmed
Paal E, Thompson LD, Frommelt RA, Przygodzki RM, Heffess CS (2001)
A clinicopathologic and immunohistochemical study of 35 anaplastic carcinomas of the pancreas with a review of the literature.
Ann Diagn Pathol 5: 129-40




Click to access Pubmed
Winter JM, Ting AH, Vilardell F, Gallmeier E, Baylin SB, Hruban RH, Kern SE, Iacobuzio-Donahue CA (2008)
Absence of E-cadherin expression distinguishes noncohesive from cohesive pancreatic cancer.
Clin Cancer Res 14: 412-8



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Electron microscopy reveals epithelial differentiation, microvilli and occasional mucin in some cases

Click for details
Cubilla AL, Fitzgerald PJ (eds)
Tumours of the Exocrine Pancreas.
Armed Forces Institute of Pathology: Washington, DC 1984



.
The prognosis is extremely poor, and average survival is just 5 months

Click to access Pubmed
Hoorens A, Prenzel K, Lemoine NR, Klöppel G (1998)
Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin.
J Pathol 185: 53-60




Click to access Pubmed
Paal E, Thompson LD, Frommelt RA, Przygodzki RM, Heffess CS (2001)
A clinicopathologic and immunohistochemical study of 35 anaplastic carcinomas of the pancreas with a review of the literature.
Ann Diagn Pathol 5: 129-40




Click to access Pubmed
Tschang TP, Garza-Garza R, Kissane JM (1977)
Pleomorphic carcinoma of the pancreas: an analysis of 15 cases.
Cancer 39: 2114-26




Click for details
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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