The laboratory investigations Trichostatin A in vitro including CEA and CA19-9 were within normal limits. EUS showed a hypoechoic mass with mixed cystic and solid components in the pancreas (Figure

2a) and FNAB showed vascular architectures with pseudopapillary pattern (Figure 2b), numerous neoplastic cells with sheet-like arrangement, several multinucleated giant cells and hemosiderin-pigments. Immunohistochemical stain revealed that the tumor cells were positive for alpha 1-antitrypsin, vimentin, beta-catenin etc. These findings were consistent with SPT with marked degenerative change. A distal pancreatectomy and splenectomy were performed (Figure 2c) and histopathological analysis showed tumor cells consisting of atypical mononuclear cells admixed with abundant osteoclastic giant cells (OGCs)(Figure 2d). The Akt inhibitor OGCs were positive for CD68 (Figure 2e). Unlike the FNAB findings, the atypical mononuclear cells were positive for cytokeratin (Figure 2f).

We finally diagnosed as UCPOGC on histopathologic examination of surgical specimens. Conclusion: A undifferentiated carcinoma with osteoclast-like giant cells of the pancreas can be misconceived as a SPT on EUS and EUS-FNAB. Key Word(s): 1. pancreas; 2. undifferentiated carcinoma with osteoclast-like giant cells; 3. solid pseudopapillary tumor Presenting Author: HYUN JONG KIM Additional Authors: CHOONG YOUNG KIM, HEE JOON KIM, CHOL KYOON CHO, JIN SHICK SEOUNG Corresponding Author: HYUN JONG KIM Affiliations: Chonnam National University Medical School, Chonnam National University Medical School, Chonnam National University Medical School, Saint Carollo Hospital Objective: Acinar cell carcinoma is a rare pancreatic neoplasm. Because of its rarity, characteristics medchemexpress of this disease have not been fully investigated. Herein, we present two cases of acinar cell carcinoma of pancreas. Methods: Case 1. A 60-year-old woman was referred to our hospital for evaluation of pancreatic mass found on CT scan. Abdominal CT and MRI showed a about 3 cm sized well marginated non-enhancing round mass with internal bleeding

in pancreatic head. A preoperative diagnosis of solid pseudopapillary tumor was made, a pylorus preserving pancreaticoduodenectomy was performed. At laparotomy, a 3 x 3 cm sized brown soft mass was found in pancreatic head. Microscopic findings revealed invasive acinar cell carcinoma. The patient discharged 17 days following surgery without any complications. 2 months following the surgery, multiple hepatic metastases were found on follow up CT scan. Results: Case 2. A 51-year-old woman visited our hospital presenting epigastric pain and poor oral intake. Abdominal CT and pancreas MRI showed lobulated enhancing soft tissue mass and multiple conglomerated amorphic cystic lesions around main duct of pancreas in body and tail.